Nutritional aspects of child and adolescent psychopharmacology

Single-micronutrient and broad-spectrum micronutrient approaches for treating mood disorders in youth and adults

Several different vitamins and minerals appear to be effective augmenting agents for mood-modifying drugs, but are not potent monotherapies in themselves for treating psychiatric disorders. In contrast, broad-spectrum micronutrient interventions appear in early trials to be as effective as psychiatric medications with fewer adverse effects for treating mood disorders, ADHD, aggressivity, and misconduct in youth and adults. Broad-spectrum treatments also may improve stress responses, cognition, and sense of well-being in healthy adults, but have been less well studied in youth. Current clinical data justify an extensive expansion of research on micronutrient mechanisms and treatments in psychiatry.

Vitamin and mineral intakes in adults with mood disorders: comparisons to nutrition standards and associations with sociodemographic and clinical variables

OBJECTIVE

The purpose of this study was to investigate the nutrient intakes of people with mood disorders.

METHOD

A cross-sectional survey using 3-day food records was carried out in 97 adults with bipolar or major depressive disorder to compare nutrient intakes with Dietary Reference Intakes and British Columbia Nutrition Survey (BCNS) data. Blood levels of selected nutrients were compared to reference ranges. Bivariate and multivariate analyses examined the effects of sociodemographic and clinical variables on nutrient intakes.

RESULTS

The average age of respondents was 46 (±13) years; most were women (n = 69) who had less than a university degree (n = 60) and whose incomes were in the government-defined lower range (n = 39). Compared with the BCNS, a larger proportion of the sample was below the estimated average requirement for thiamin (26% vs 8%), riboflavin (21% vs 4%), folate (64% vs 27%), phosphorous (12% vs 1%), and zinc (39% vs 15%; all P < 0.0001), as well as vitamin B(6) (25% vs 16%) and vitamin B(12) (27% vs 8%; both P < 0.05). Combined intakes of food and supplements helped reduce the prevalence of inadequacy; however, with supplementation, the proportion of participants exceeding the tolerable upper intake levels for niacin, vitamin B(6), folate, vitamin C, calcium, magnesium, iron, and zinc ranged from 1%-8%. Income, relationship status, age, gender, and caloric intake were associated with intakes of many nutrients. Types of medications were associated with nutrient intakes, as lower intakes of thiamin and phosphorous (P < 0.05) were found with antidepressant use, higher calcium and iron intakes (P < 0.05) were associated with antianxiety medication use, and magnesium intakes were increased with mood stabilizers (regression coefficient = 52.61, P < 0.05, 95% confidence interval = 0.74 to 104.48).

CONCLUSIONS

Adults with mood disorders are at risk for many nutrient inadequacies, as well as occasional excesses; social, demographic, and clinical factors may affect their nutrient intakes.

Food intake and blood cholesterol levels of community-based adults with mood disorders

BACKGROUND

A growing body of literature links nutrition to mood, especially in epidemiological surveys, but there is little information characterizing food intake in people with diagnosed mood disorders.

METHODS

Food intake obtained from 3-day food records was evaluated in 97 adults with mood disorders, whose diagnoses were confirmed in structured interviews. Information from a population nutrition survey, national guidelines for nutritional intakes (Eating Well with Canada's Food Guide) and North American dietary guidelines (Dietary Reference Intakes) was utilized to evaluate the quality of their food intake.

RESULTS

Compared to the regional nutrition survey data and national guidelines, a greater proportion of study participants consumed fewer of the recommended servings of grains (p < 0.001) and vegetables and fruits (p < 0.05), and less than the lower boundary of the Adequate Macronutrient Distribution Range (AMDR) for α-linolenic acid (p < 0.001). The study sample also had greater intakes of high-fat whole grain products (p < 0.01), processed meats (p < 0.00001), and higher sugar, fat or salty foods (p < 0.00001). Of the 1746 total meals and snacks consumed, 39% were from sources outside the home, suggesting a lack of time devoted to meal preparation. Finally, a subsample of 48 participants agreed to have blood tests: 44% had mild hypercholesterolemia (> 5.2 and ≤ 6.2 mmol/L) and 21% had hypercholesterolemia (> 6.2 mmol/L).

CONCLUSIONS

Much research has proposed multiple ways in which healthier diets may exert protective effects on mental health. The results of this study suggest that adults with mood disorders could benefit from nutritional interventions to improve diet quality.