Article

The effects of an oral multivitamin combination with calcium, magnesium, and zinc on psychological well-being in healthy young male volunteers: A double-blind placebo-controlled trial

July 2000
Psychopharmacology 150(2):220-5

DOI:10.1007/s002130000406

Source
PubMed

Authors:

Chris Ring

University of Birmingham

Gonneke Willemsen

Vrije Universiteit Amsterdam

Vitamin and mineral supplements may be associated with improved psychological status. The present study tested the effects of a multivitamin and mineral supplement (Berocca) on psychological well-being. In a double-blind randomised-control trial, 80 healthy male volunteers were assigned to either Berocca or placebo. Questionnaires measuring psychological state were completed and a blood sample taken to determine plasma zinc concentration on day 1 (pre-treatment) and again on day 28 (post-treatment), following 28 days of treatments, which were administered at a dosage of one tablet daily. At the end of the study, the acceptability of the treatment and participants' awareness of treatment condition were assessed, as was habitual dietary behaviour. Relative to placebo, treatment with Berocca was associated with consistent and statistically significant reductions in anxiety and perceived stress. Participants in the Berocca group also tended to rate themselves as less tired and better able to concentrate following treatment. In addition, participants registered more somatic symptoms following placebo than following Berocca. These effects cannot be attributed to differences in the acceptability of the two treatments or to participants guessing what treatment they received. These findings demonstrate that Berocca significantly reduces anxiety and perceived stress.

Poor sleep quality among young adults: The role of anxiety, depression, musculoskeletal pain, and low dietary calcium intake

Article

May 2020

Purpose This study examined the relationships between sleep quality, anxiety, depression, musculoskeletal pain (MSP), and calcium intake. Design and Methods In this cross‐sectional study (N = 1422), sleep was assessed using the Pittsburgh Sleep Quality Index, anxiety and depression were assessed using the Hospital Anxiety and Depression Scale, and calcium intake and MSP were assessed by self‐reporting. Findings Poor sleep quality was reported by 62.66% of the participants. The participants with poor sleep quality reported lower calcium intake, higher anxiety and depression levels, more severe MSP, and multisite pain. Anxiety, depression, low calcium intake, and multisite pain were significant predictors of poor sleep quality. Anxiety was predicted by poor sleep quality, depression, multisite pain, and sex (ie, female). Depression was predicted by anxiety, poor sleep quality, and low calcium intake. Practical Implications The findings underscore the role of low calcium intake in the development of sleep problems, anxiety, depression, and MSP. Individuals with these conditions should be advised to increase their calcium intake.

Increased Posterior Cingulate Functional Connectivity Following 6-Month High-Dose B-Vitamin Multivitamin Supplementation: A Randomized, Double-Blind, Placebo-Controlled Trial

Article

Full-text available

Sep 2019

B vitamins are essential for optimal brain and body function, and are particularly important for cortical metabolic processes that have downstream effects on mitigating oxidative stress. Oxidative stress has been linked to poor psychological outcomes including psychological distress, which has wide-reaching implications for the community and the workplace. Given work-related stress has been associated with poor mental health outcomes, high-dose B vitamin supplementation may be effective in improving brain function and psychological outcomes via attenuation of oxidative stress. This randomized, double-blind, placebo-controlled study investigated psychological outcomes following 6-month supplementation of a high-B-vitamin multivitamin in a large sample of healthy adults (n = 108, aged 30–70 years), as well as changes in default mode network functional connectivity in a subset of the original sample (n = 28). Improvements in occupational stress, general health, perceived stress, depressive symptoms, and mood profiles were identified for both active and placebo groups over time (p < 0.05 corrected). Seed-based functional connectivity analysis centered on the posterior cingulate cortex (PCC) showed that connectivity between the PCC and the caudate increased for the active treatment group, but decreased for the placebo group (p < 0.05 corrected). These findings reveal a substantial intervention effect for both active and placebo treatments, which could in part be associated with a placebo effect in subjective measures. There was, however, a significant treatment effect in the objective measure of functional connectivity, suggesting that reduced psychological stress and high-B-vitamin multivitamin supplementation may lead to an increase in DMN and caudate functional connectivity, which might reflect a strengthening of neurocircuitry within areas associated with reward and emotion at rest. Future studies should consider a placebo run-in methodology to reduce the placebo effect on the subjective measures of stress.

Effects of Vitamin and Mineral Supplementation on Stress, Mild Psychiatric Symptoms, and Mood in Nonclinical Samples: A Meta-Analysis

Article

Full-text available

Jan 2013
PSYCHOSOM MED

Sara Long

Objective: Biochemical processes in the brain affect mood. Minor dietary inadequacies, which are responsible for a small decline in an enzyme’s efficiency, could cumulatively influence mood states. When diet does not provide an optimal intake of micronutrients, supplementation is expected to benefit mood. This meta-analysis evaluated the influence of diet supplementation on mood in nonclinical samples. Methods: Databases were evaluated and studies were included if they considered aspects of stress, mild psychiatric symptoms, or mood in the general population; were randomized and placebo-controlled; evaluated the influence of multivitamin/ mineral supplements for at least 28 days. Eight studies that met the inclusion criteria were integrated using meta-analysis. Results: Supplementation reduced the levels of perceived stress (standard mean difference [SMD] = 0.35; 95% confidence interval [CI] = 0.47Y0.22; p = .001), mild psychiatric symptoms (SMD = 0.30; 95% CI = 0.43Y0.18; p = .001), and anxiety (SMD = 0.32; 95% CI = 0.48Y0.16; p G .001), but not depression (SMD = 0.20; 95% CI = 0.42Y0.030; p G .089). Fatigue (SMD = 0.27; 95% CI = 0.40Y0.146; p G .001) and confusion (SMD = 0.225; 95% CI = 0.38Y0.07; p G .003) were also reduced. Conclusions: Micronutrient supplementation has a beneficial effect on perceived stress, mild psychiatric symptoms, and aspects of everyday mood in apparently healthy individuals. Supplements containing high doses of B vitamins may be more effective in improving mood states. Questions about optimal levels of micronutrient intake, optimal doses, and active ingredients arise. Key words: anxiety, depression, minerals, mood, stress, vitamins.

Improvements to mood, stress and loneliness following 12-week multivitamin supplementation in older adults: a randomised, placebo-controlled, trial

Article

Full-text available

Oct 2024

Background Research has indicated the potential for multivitamin-mineral (MVM) supplementation to improve aspects of wellbeing and cognitive function in older adults via a range of biological mechanisms. However, outside of cognitive function and mood, this research rarely assesses other outcomes that are pertinent to the daily lives of older adults. The current study aimed to investigate the effectiveness of a MVM supplement on meaningful outcomes of everyday functioning in older adults. Methods This randomised, double-blind, placebo-controlled, parallel groups trial investigated the effects of 12-week MVM supplementation on measures of wellbeing, mood, and memory; physical health and activity; and social interaction and loneliness. Outcomes were measured at baseline and after 12 weeks in a sample of 228 (124 female) older adults ( > 70 years). Results MVM supplementation had no effect on the primary outcome of wellbeing (p = 0.29 in males, p = 0.421 in females), but led to increased feelings of friendliness in females (p = 0.045). In males, following MVM, there were lower levels of prolonged stress reactivity (p = 0.007), lower overall stress reactivity (p = 0.019), and lower emotional loneliness (p = 0.042). Conclusion This study provides novel evidence of increased friendliness and decreased stress reactivity and loneliness following MVM supplementation in older adults. These findings support the exploration of broader functions pertinent to aspects of daily living in older adults. Sex differences in response highlight the importance of exploring effects in men and women separately and support a recommendation for the inclusion of diverse samples in future research that are representative of the population.

A real-world evidence study evaluating consumer experience of Supradyn Recharge or Supradyn Magnesium and Potassium during demanding periods

Article

Jun 2023

Background: Challenging periods and/or mild micronutrient deficiencies may result in a lack of energy and general fatigue, frequently occurring in the general population. Supradyn Recharge and Supradyn Magnesium and Potassium (Mg/K) are multimineral/vitamin supplements formulated to ensure adequate daily intake of micronutrients. We conducted an observational study addressing consumption behaviour, reasons for intake, frequency of intake, and consumer experiences, satisfaction and characteristics under real-life conditions. Methods: This was a retrospective, observational study carried out with two computer-aided web quantitative interviews. Results: A total of 606 respondents (almost equally split between men and women; median age 40 years) completed the questionnaires. The majority indicated having a family, a job and a good level of education; they stated to be long-time and daily users, reporting an average daily intake of 6 days a week. More than 90% of consumers claimed they were satisfied, would use the products again and recommend them; over two-thirds felt the value for money was good. Supradyn Recharge has been mainly used to support lifestyle change and mental resilience, seasonal changes, and post-illness recovery. Supradyn Mg/K has been used to sustain or regain energy levels during hot weather or physical activity and as a support against stress. Users claimed a positive impact on quality of life. Conclusion: Overall, the perception of benefit by consumers was extremely positive as reflected in their consumption behaviour, the majority of whom stated to be long-time users and daily consumers, with an average daily intake of 6 days for both products. These data complement and add up to the results of Supradyn clinical trials.

The effect of multivitamins on anxiety and depression in patients undergoing methadone maintenance treatment: A double-blind randomized controlled trial

Article

May 2023
INT J PSYCHIAT MED

Background: The prevalence of addiction is increasing in the world. Methadone Maintenance Treatment (MMT) can be associated with severe stress and mild to moderate depressive symptoms. Vitamins and minerals are commonly found in multivitamins, and these complements seem to improve mood. Therefore, the aim of this study was to evaluate the effect of multivitamins on anxiety and depression in patients undergoing MMT in a double blind randomized trial. Methods: The study was designed as a double-blind, randomized clinical trial and involved 70 male MMT patients over the age of 18. Participants were randomized to one of two groups, those receiving multivitamins or those receiving a placebo for 12 weeks. The multivitamin capsule includes vitamin E, B1, B2, B3, B5, B6, B12, C, biotin, folic acid, and zinc. Anxiety and depression were measured using standard questionnaires, before and after the intervention. Results: The between-group comparison (i.e., intervention vs. placebo) indicated there was no significant difference in anxiety scores; however, there was a significant between-group difference in depression scores, favoring the intervention group. Conclusions: Multivitamin supplementation improved depression but did not have a significant impact on anxiety in patients undergoing MMT.

Overactive bladder and associated psychological symptoms: A possible link to vitamin D and calcium: ABDUL-RAZZAK et al.

Article

Mar 2019

Introduction Overactive bladder (OAB) is a prevalent syndrome that is associated with multiple urinary tract symptoms and could affect the patient's quality of life and well‐being. Vitamin D is shown to be linked to OAB syndrome, which exacerbated by stress conditions. This study evaluated the relationship between vitamin D status, daily calcium intake and OAB, and the associated psychological symptoms. Methods The study included 55 patients with OAB and 129 healthy controls. Psychological symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). Serum vitamin D was measured. Patients with OAB with low vitamin D level received orally vitamin D supplementation. Urinary symptoms, psychological symptoms, and quality of life were evaluated before and after vitamin D supplementation plus dairy products. Results Vitamin D deficiency was more prevalent in cases (80%) vs controls (34.9%). Depression (43.7% vs 20.2%) and anxiety (52.8% vs 10.9%) scores (HADS, ≥8) were also more frequent in cases vs controls, respectively. Some 85.5% of the patients’ group had musculoskeletal pain vs 0.0% for the control. Depression was negatively correlated with daily calcium intake and positively with anxiety. Logistic regression analysis revealed that age, vitamin D, and anxiety scores were significant predictors of OAB. Vitamin D supplements with increased calcium intake had significant improvement in urinary symptoms, psychological distress, and quality of life. Conclusions Vitamin D supplements and improved calcium intake may improve urinary and psychological symptoms and quality of life among patients with OAB syndrome. Assessment for vitamin D status in patients with OAB may be warranted.

Improving the efficiency of nootropic therapy

Article

Jan 2016

O. A. Shavlovskaya

Dietary Supplementation to manage anxiety and stress: Hope, hype or research-based evidence?

Article

Feb 2017

Delia McCabe

The impact of essential fatty acid, B vitamins, vitamin C, magnesium and zinc supplementation on stress levels in women: A systematic review

Article

Feb 2017

BACKGROUND: Women juggling multiple roles in our complex society are increasingly experiencing psychological stress. Dietary supplementation to manage stress is widespread despite limited supporting evidence. A systematic review of the available literature was undertaken to investigate the efficacy of specific dietary supplements in managing female stress and anxiety. OBJECTIVES: To identify the impact of essential fatty acids (EFAs), B vitamins, vitamin C, magnesium and/or zinc, consumed as dietary supplements to the daily diet, on female stress and anxiety levels. INCLUSION CRITERIA TYPES OF PARTICIPANTS: Women aged 18 years and over, who had participated in a study where stress and/or anxiety were assessed. TYPES OF INTERVENTION(S): Dietary supplementation with EFAs, B vitamins, vitamin C, magnesium and/or zinc. TYPES OF COMPARATORS: Supplements, either alone or combined, were compared with either no intervention or placebo. TYPES OF STUDIES: Randomized controlled and pseudo-randomized trials were included. OUTCOMES: Stress and anxiety were assessed using self-report or physiological outcome measures. SEARCH STRATEGY: Published and unpublished studies were sought via MEDLINE (via PubMed), Embase, Scopus, CINAHL, PsycINFO, PsycARTICLES, MedNar, National Institute of Mental Health and the International Association for Women's Mental Health. METHODOLOGICAL QUALITY: Methodological quality was evaluated using standardized critical appraisal instruments from the Joanna Briggs Institute. DATA EXTRACTION: Data were extracted using the standardized data extraction instruments from the Joanna Briggs Institute. DATA SYNTHESIS: Due to heterogeneity of the included studies, narrative synthesis was performed. RESULTS: Fourteen studies were included in this review. Essential fatty acids were effective in reducing perceived stress and salivary cortisol levels during pregnancy and anxiety in premenstrual women, and anxiety during menopause in the absence of depression, but were ineffective when depression was disregarded. Disregarding the hormonal phase, EFAs were ineffective in reducing stress or anxiety in four groups of women. Combined magnesium and vitamin B6 supplementation reduced premenstrual anxiety but had no effect when used in isolation and did not affect stress in women suffering from dysmenorrhea when combined or used in isolation. Older women experienced anxiety reduction using vitamin B6, but not folate or vitamin B12. High-dose sustained-release vitamin C was effective in reducing anxiety and blood pressure in response to stress. CONCLUSION: The current review suggests that EFAs may be effective in reducing prenatal stress and salivary cortisol and may reduce anxiety during premenstrual syndrome and during menopause in the absence of depression. Magnesium and vitamin B6 may be effective in combination in reducing premenstrual stress, and vitamin B6 alone may reduce anxiety effectively in older women. High-dose sustained-release vitamin C may reduce anxiety and mitigate increased blood pressure in response to stress. IMPLICATIONS FOR PRACTICE: Essential fatty acids may be effective in reducing prenatal stress and salivary cortisol levels, and premenstrual or menopausal anxiety in the absence of depression. Combining magnesium and vitamin B6 may reduce premenstrual anxiety and vitamin B6 may reduce anxiety in older women. High-dose sustained-release vitamin C may reduce anxiety and mitigate increased blood pressure in response to stress. IMPLICATIONS FOR RESEARCH: Investigating supplementation in longer term studies is warranted and should include compliance testing, the use of inert substances as controls and reliable outcome measures.

The Effects of Four-Week Multivitamin Supplementation on Mood in Healthy Older Women: A Randomized Controlled Trial

Article

Full-text available

Nov 2016
EVID-BASED COMPL ALT

b>Objective . Nutritional deficiencies have been associated with cognitive decline and mood disturbances. Vitamin intake can influence mood and randomized controlled trials have demonstrated that multivitamin supplements are capable of reducing mild symptoms of mood dysfunction. However, few studies have focussed on healthy older women. Methods . This study investigated the effects of four weeks' multivitamin supplementation on mood in 76 healthy women aged 50-75 years. Mood was assessed before and after intervention in the laboratory using measures of current mood and retrospective experiences of mood over the past week or longer. Mobile phones were used to assess changes in real-time mood ratings, twice weekly in the home. Results. There were no multivitamin-related benefits identified for measures of current mood or reflections of recent mood when measured in the laboratory. In-home assessments, where mood was rated several hours after dose, revealed multivitamin supplementation improved ratings of stress, with a trend to reduce mental fatigue. Conclusions. Over four weeks, subtle changes to stress produced by multivitamin supplementation in healthy older women may not be detected when only pre- and posttreatment mood is captured. In-home mobile phone-based assessments may be more sensitive to the effects of nutritional interventions compared to traditional in-laboratory assessments.

Score of fear of COVID-19 and physical activity level are related to the habitual consumption of dietary supplements

Article

Full-text available

Sep 2024
PLOS ONE

The measures implemented to contain the COVID-19 pandemic resulted in both behavioral and lifestyle changes. The “Changes in Lifestyle-Related Behavior” instrument was developed to assess lifestyle-related behaviors in the Indian population. However, considering current knowledge, this instrument was not adapted for the Brazilian population. In addition, the relationship between fear of COVID-19 and consumption of dietary supplements has not yet been evaluated. Thus, we aimed to investigate the relationship between the use of dietary supplements with lifestyle behavior and the fear of COVID-19, as well as assess the psychometric properties of the Brazilian version of the “Changes in Lifestyle-Related Behavior” instrument. An online questionnaire assessed sociodemographic, occupational, anthropometric, physical activity (International Physical Activity Questionnaire—short form), fear of COVID-19, and lifestyle behavior data from 416 Brazilian adults (237 females; 18-60y). Mann-Whitney, Chi-square test, exploratory, and confirmatory analyses were applied. Exploratory and confirmatory analyses showed a satisfactory adequacy level of the questionnaire (CMIN/DF = 2.689; Cronbach’s α = 0.60) with 5 domains (‘Bad eating behavior’; ‘Healthy eating’; ‘Sleep quality’; ‘Interest in cooking’; ‘Number of portions and meals’). Lower fear of COVID-19 scores and higher levels of physical activity were found in participants who reported previous dietary supplement intake during the pandemic; in addition, the group that did not ingest dietary supplements reported greater changes in stress and anxiety levels during the pandemic (p<0.05). The intake of dietary supplements before the pandemic was associated with greater energy expenditure and better coping with the fear of COVID-19 during the pandemic. Additionally, the Changes in Lifestyle-Related Behavior tool can be used to assess lifestyle-related variables during the pandemic.

Severity of premenstrual symptoms among women with musculoskeletal pain: relation to vitamin D, calcium, and psychological symptoms

Article

Full-text available

Apr 2024

Premenstrual syndrome (PMS) has various symptoms that occur during the luteal phase of the menstrual cycle and subside after menstruation. Anxiety and depression are prevalent in women with PMS and may exacerbate the severity of PMS. Vitamin D and calcium deficiency may have a role in developing anxiety, depression, and musculoskeletal pain (MSP). The aim of this study was to evaluate selected premenstrual symptoms in relation to serum vitamin D levels, daily calcium consumption, and psychological symptoms among women with MSP. The study population consisted of 108 women with MSP and 108 healthy controls. Information about premenstrual symptoms and calcium consumption were collected. Psychological symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). Vitamin D was determined by electrochemiluminescence immunoassay. Women with MSP had lower serum vitamin D levels, lower daily calcium consumption, higher HADS scores for anxiety and depression, and higher frequency of severe premenstrual symptoms including fatigue, headache, irritability, mood swings, anxiety, depression, and social withdrawal compared to controls (P < 0.01). Abnormal HADS scores for anxiety and depression were associated with increased severity of premenstrual symptoms (P < 0.05). Deficient vitamin D and calcium consumption were associated with abnormal HADS scores for anxiety and depression (P < 0.05) and with increased severity of premenstrual headache, irritability, anxiety, and depression (P < 0.05). Low calcium consumption was associated with increased severity of premenstrual irritability, anxiety, depression, and social withdrawal (P < 0.05). The results suggest that vitamin D deficiency, low calcium consumption, psychological symptoms, and MSP could be interrelated and implicated in the etiology severe premenstrual symptoms. Further studies are necessary to assess whether vitamin D and calcium supplements can relieve MSP and premenstrual symptoms.

The effect of vitamin D deficiency in children with overactive bladder related urinary incontinence

Article

Full-text available

Mar 2022

Purpose: Overactive bladder (OAB) is a common syndrome associated with lower urinary tract symptoms (LUTS), especially urinary incontinence in children, which may affect the patient's quality of life (QoL). Vitamin D deficiency has been shown to be associated with OAB syndrome. This study evaluated the relationship between vitamin D status and OAB-related symptoms and QoL in children. Materials and methods: The study included 52 pediatric patients with OAB-related urinary incontinence and 41 healthy children. LUTS were assessed using the Dysfunctional Voiding and Incontinence Symptoms Score (DVISS) questionnaire, and QoL was assessed using the Pediatric Incontinence Questionnaire (PINQ). Oral vitamin D supplementation was given to patients with OAB with vitamin D deficiency. Urinary symptoms and QoL were evaluated before and after vitamin D supplementation. Results: Vitamin D deficiency was more common in the OAB group (75%) than in the control group (36.6%). Logistic regression analysis revealed that vitamin D status (<20ng/mL) was a significant predictor of OAB. Both pre-treatment and post-treatment DVISS and PINQ scores showed a positive correlation. After vitamin D supplementation, 8 (23.5%) patients had a complete response and 19 (55.9%) patients had a partial response. Significant improvement in QoL was also achieved. Conclusions: Vitamin D deficiency is more common in children with urinary incontinence and OAB than in healthy children. Although vitamin D deficiency is not routinely evaluated for every patient, it should be evaluated in treatment-resistant OAB cases. Vitamin D supplementation may improve urinary symptoms and QoL in patients with OAB.

The efficacy of vitamin B6 as an adjunctive therapy to lithium in improving the symptoms of acute mania in patients with bipolar disorder, type 1; a double‐blind, randomized, placebo‐controlled, clinical trial

Article

Full-text available

Oct 2021

Objective Vitamin B6 has been linked to a variety of probable roles, including anti‐inflammatory, homocysteine‐lowering, serotonin‐regulating, and dopamine‐lowering. In this study, we investigated the possible effect of vitamin B6 on bipolar disorder in manic episode with psychotic feature in a placebo‐controlled double‐blind clinical trial in a psychiatric hospital. Methods This study was performed on 50 patients who were equally divided into two groups (each group included 25 patients) using 80 mg of vitamin B6 daily or placebo. At the beginning and end of the study, they were evaluated for lab tests, inflammatory biomarkers and level of blood homocysteine. Also, at the baseline and in weeks 2, 4, and 8, they were evaluated based on the anthropometric measurements, score obtained from the Young Mania Questionnaire, Mini‐Mental State Examination (MMSE), and the Pittsburgh Sleep Questionnaire. Results Accordingly, based on Yang Mania scoring scale, no significant difference was observed between the two groups receiving vitamin B6 and placebo (22.68 ± 5.39 vs. 21.80 ± 5.39 [p‐value = .51]). Based on MMSE, significant improvement in cognitive status was obtained in group placebo compared to vitamin B6 group (25.24 ± 1.96 vs. 24.40 ± 3.25, respectively [p‐value = .01]). At the Pittsburg scale (total, there was no statistically significant difference between the two groups receiving vitamin B6 and placebo (1.04 ± 0.20 vs. 0.48 ± 0.50 [p‐value = .23]). Additionally, no significant difference was observed between the two groups regarding the anthropometric status. Conclusions According to this study, the daily dose of 80 mg of vitamin B6 for 8 weeks in patients with bipolar disorder in the manic episode with psychotic feature treated daily with lithium, was not associated with a significant improvement in mood status compared to the control–placebo group. It is recommended to perform similar studies in a multi‐center manner with a larger sample size and longer duration.

Nutritional supplementation in the treatment of violent and aggressive behavior: A systematic review

Article

Feb 2021
AGGRESSIVE BEHAV

Aggression in correctional and psychiatric settings is relatively common and has a negative effect on physical and mental health both among inmates/clients and staff, as well as organizational-level functioning. The aim of the present study was to critically review the evidence on the effectiveness of nutritional supplements in reducing aggression and violence to contribute to a better understanding of options available for managing aggressive behaviors in adults. The EMBASE, MEDLINE, PsycINFO, Cochrane Library, and PubMed databases were searched for effectiveness studies published in English anytime up until March 2020. Study quality was assessed using the Mixed Methods Appraisal Tool. Altogether, 14 studies met inclusion criteria; 2 investigated micronutrients, 10 examined macronutrients, while further 2 examined a combination of micro and macronutrients. Out of the 14 studies, 5 reported a beneficial effect of nutritional supplementation (omega-3 fatty acids, vitamins/minerals, S-adenosyl- l-methionine, or tryptophan). Five studies did not report a significant beneficial effect of nutritional supplementation (omega-3 fatty acids, folic acid, tryptophan, broad range supplement containing vitamins and fatty acids, and fatty acids in augmentation with valproic acid), while four studies reported mixed effects (on l-tryptophan, broad-range micronutrient formula, folic acid, and omega-3 fatty acids). The results overall indicated that research in this area is in its infancy: very few studies examined the same composition of nutritional supplementation and when they did so the results were contradictory. The methodological shortcoming of existing studies and directions for future research are discussed to facilitate high-quality research in this evolving area of nutritional psychiatry.

Nutrition and behavioral health disorders: depression and anxiety

Article

Full-text available

May 2020
NUTR REV

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.

Community pharmacists’ recommendations for natural products for stress in Melbourne, Australia: A simulated patient study

Article

Full-text available

Mar 2020

Background: Community pharmacists are often the first health professional approached to provide treatment for health issues, including the important mental health challenge, stress. Over-the-counter products for stress almost always are complementary and alternative medicines (CAM) and in Australia no protocol exists for their recommendation and sale in community pharmacies. Objective: To assess the quality and relevance of community pharmacists' information gathering (questioning), counselling and product selection when interacting with customers requesting a CAM product for stress and consequently determine whether Australian pharmacy practice indicates the need for guidelines similar to those provided for 'pharmacy only' (S2) and 'pharmacist only' (S3) medicines. Methods: A covert simulated patient was used to investigate the response of pharmacists to a request for a natural product for stress. The SPs documented the details of the pharmacist-simulated patient interaction immediately on leaving the pharmacy and then re-entered the pharmacy to debrief the pharmacist. The quality of the interaction was scored as a Total CARE (check, assess, respond, explain) Score, based on anticipated questions and counselling advice. The appropriateness of the product was scored as a Product Efficacy Score, based on evidence-based literature. Results: Data from 100 pharmacies was provided. Information gathering illustrated by the questioning components Check and Assess (C and A) of the total CARE score by pharmacists was poor. The number of questions asked ranged from zero (13 pharmacists) to 7 (four pharmacists), the average being 3.1 (SD 1.9). Provision of advice was generally better (a description of the suggested product was offered by 87 pharmacists) but was lacking in other areas (duration of use and side effects were explained by only 41 and 16 pharmacists respectively). The most common product suggested was B-group vitamins (57 pharmacists) followed by a proprietary flower essence product (19 pharmacists). A two-step cluster analysis revealed two sub-groups of pharmacists: one cluster (74 pharmacists) with a high Total CARE score provided an appropriate product. The other cluster (20 pharmacists) had a low total CARE score and provided an inappropriate product. Conclusions: The pharmacy visits revealed major shortcomings in questioning, counselling and product recommendation. There is a need to develop guidelines for pharmacists to make evidence-based decisions in recommending complementary and alternative medicine.

Broad spectrum micronutrient formulas for the treatment of symptoms of depression, stress and/or anxiety: a systematic review

Article

Full-text available

Mar 2020

Introduction: Vitamin and mineral nutritional supplements are becoming increasingly popular as alternative treatments for anxiety and depression, as issues such as side effects from medication, failure to respond to psychotherapy and workforce limitations pose barriers for successful treatment. Areas covered: This review covered double-blind, randomized controlled trials (DBRCTs) testing formulas including at least four vitamins and/or minerals used for the treatment of symptoms of anxiety, stress or depression in adults not currently taking medication for psychiatric difficulties. Expert opinion: The majority of the 23 trials reviewed were conducted on people without psychological difficulties, limiting the generalizability of the results to people with diagnosed mood and anxiety difficulties. 16 studies demonstrated positive effects for symptoms of anxiety, depression or stress. Micronutrient supplementation in healthy nonclinical adults has limited benefits for mood and anxiety symptoms, although may convey some subtle general improvements. The evidence for adults with physical or mental ill health is more positive although limited by small samples and variability in nutrients studied. Broad spectrum nutrient products may be more effective than a selected few. While an effect of micronutrients cannot be dismissed, the variability of the studies makes it extremely challenging to identify specific treatment benefits.

Nutritional Factors, Physical Health and Immigrant Status Are Associated with Anxiety Disorders among Middle-Aged and Older Adults: Findings from Baseline Data of The Canadian Longitudinal Study on Aging (CLSA)

Article

Full-text available

Feb 2020
Int J Environ Res Publ Health

The main purpose of this study was to compare the lifetime prevalence of anxiety disorders among foreign-born and Canadian-born adults in middle and later life. Using baseline data of the Canadian Longitudinal Study on Aging (2010–2015), multivariable binary logistic regression was conducted to investigate anxiety diagnosis and immigrant status, while controlling for socio-economic, health-related, and nutrition covariates. Of 26,991 participants (49.3% men, 82.5% Canadian born, 58.5% aged 45–65 years), the overall prevalence of self-reported physician diagnosis of anxiety disorders was 8.5%, with immigrants being lower than Canadian-born respondents (6.4% vs. 9.3%, p < 0.001). After accounting for all covariates, the adjusted odds ratio (aOR) for anxiety disorders was lower among immigrants (aOR = 0.77, 95% CI: 0.67–0.88) compared to those who were Canadian born. Identified risk factors included: younger age (aORs = 1.79–3.52), being a woman (aOR = 1.25, 95% CI: 1.07–1.46), single status (aOR = 1.27, 95% CI: 1.09–1.48), lower income (aORs = 1.28–2.68), multi-morbidities (aORs = 2.73–5.13), chronic pain (aOR = 1.31, 95% CI: 1.18–1.44), lifetime smoking ≥ 100 cigarettes (aOR = 1.35, 95% CI: 1.23–1.48), BMI < 18.5 (aOR = 1.87, 95% CI: 1.20–2.92), body fat ≥ 26% (aORs = 1.28–1.79), fruit and vegetable intake (< 3/day; aORs = 1.24–1.26), and pastry consumption (> 1/day; aOR = 1.55, 95% CI: 1.12–1.15) (p < 0.05). Targeting socio-economic and nutritional risk factors may reduce the burden of anxiety disorders in middle and late adulthood.

Novel Mineral-Vitamin Treatment for Reduction in Cigarette Smoking: A Fully Blinded Randomized Placebo-Controlled Trial

Article

Oct 2019
NICOTINE TOB RES

Introduction: Many smokers do not achieve abstinence using current smoking cessation options. This randomized controlled trial (RCT) investigated a novel nutritional supplement to assist with quitting smoking. Methods: Following a baseline phase where cigarettes per day and nicotine dependence were measured, participants (n = 107) were randomized to placebo (n = 50) or micronutrient conditions (n = 57). A 4-week pre-quit phase permitted titration up to 12 capsules/day. During the quit phase (12 weeks), participants were registered with a public Quitline while consuming micronutrients or placebo. Carbon monoxide levels were measured to confirm smoking cessation. Results: Forty-five (42%) participants completed the trial. Treatment and placebo groups did not differ on the primary outcome of continuous abstinence at 12 weeks using intention-to-treat analysis; however, 28% of the micronutrient-treated group had quit versus 18% for placebo (odds ratio [OR] = 1.78, 95% confidence interval [CI] = 0.71 to 4.48), with number needed to treat = 10. Comparison of cigarette consumption (cigarettes per day) between micronutrient and placebo groups showed that those taking micronutrients reported reduced consumption throughout the trial, notably at pre-quit weeks 1 and 4, and at quit phase week 4. There were no serious adverse events, blinding was successful, and there were no substantive group differences in side effects or dropout rate. Conclusion: This is the first RCT investigating the impact of micronutrients on smoking reduction, finding that micronutrients reduced harm through reduction in number of cigarettes smoked relative to placebo. The small sample and high dropout rate limit confidence in the conclusions and generalizability of the study; however, assessed by number needed to treat, micronutrients are comparable to other smoking cessation treatments but with fewer side effects. Future research using larger and longer trials including cost-effectiveness and biomarker measures is encouraged. Implications: Micronutrients are being increasingly studied for the treatment of psychiatric conditions, but direct application of micronutrients as a treatment for addictions is novel. There is extensive evidence that micronutrients alleviate stress. Given that tobacco smoking is often used to cope with stress, taking micronutrients may moderate the stress of withdrawal and increase the chance of a successful quit attempt. This study is the first known RCT to investigate the use of micronutrients to support smoking cessation. Treatments that are safe, effective, relatively inexpensive, and readily available are needed and micronutrient supplements offer one such possible alternative.

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

Article

Full-text available

Sep 2019

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

Combined therapy of neurasthenia in general medical practice

Article

Full-text available

Jan 2016

The Effect of a High-Dose Vitamin B Multivitamin Supplement on the Relationship between Brain Metabolism and Blood Biomarkers of Oxidative Stress: A Randomized Control Trial

Article

Full-text available

Dec 2018

A diet rich in B-group vitamins is essential for optimal body and brain function, and insufficient amounts of such vitamins have been associated with higher levels of neural inflammation and oxidative stress, as marked by increased blood plasma homocysteine. Neural biomarkers of oxidative stress quantified through proton magnetic spectroscopy (1H-MRS) are not well understood, and the relationship between such neural and blood biomarkers is seldom studied. The current study addresses this gap by investigating the direct effect of 6-month high-dose B-group vitamin supplementation on neural and blood biomarkers of metabolism. Using a randomized, double-blind, placebo-controlled design, 32 healthy adults (20 female, 12 male) aged 30–65 years underwent blood tests (vitamin B6, vitamin B12, folate, and homocysteine levels) and 1H-MRS of the posterior cingulate cortex (PCC) and dorsolateral prefrontal cortex (DLPFC) before and after supplementation. Results confirmed the supplement was effective in increasing vitamin B6 and vitamin B12 levels and reducing homocysteine, whereas there was no change in folate levels. There were significant relationships between vitamin B6 and N-acetylaspartate (NAA), choline, and creatine, as well as between vitamin B12 and creatine (ps < 0.05), whereas NAA in the PCC increased, albeit not significantly (p > 0.05). Together these data provide preliminary evidence for the efficacy of high-dose B-group supplementation in reducing oxidative stress and inflammation through increasing oxidative metabolism. It may also promote myelination, cellular metabolism, and energy storage.

Vitamin D as potential antidepressant in outpatients with musculoskeletal pain

Article

Full-text available

Aug 2018
INT J CLIN PHARM TH

Objective: To determine the incidence of vitamin D deficiency, anxiety, and depression disorders in an outpatient population with musculoskeletal pain (MSP), and to evaluate the effects of correcting a vitamin D deficiency on MSP and psychological symptoms. Materials and methods: A total of 261 outpatients with MSP and 100 controls were involved. The Hospital Anxiety and Depression Scale (HADS) was used to assess psychological symptoms. Serum vitamin D was measured. Outpatients with vitamin D insufficiency and deficiency received oral vitamin D supplementation. Pain severity and psychological symptoms were evaluated before and after vitamin D supplementation plus dairy products. Results: Vitamin D deficiency was found in 88.7% of participants in the MSP group and 69% of controls. Clinical anxiety was reported by 38.3% of participants in the MSP group and 9% of controls, while clinical depression was reported by 31.8% of participants in the MSP group and 2% of controls. Multisite pain was significantly and positively associated with anxiety, depression, and pain severity, and was inversely associated with daily calcium intake. Anxiety was inversely associated with vitamin D level, daily calcium intake, and age. A similar pattern was observed for depression. MSP was the most significant independent predictor of anxiety (OR = 7.84) and depression (OR = 5.89). Relative to baseline, all measured outcome parameters significantly improved after vitamin D supplementation plus increased intake of dairy products. Conclusion: Low serum vitamin D is associated with MSP along with low calcium intake, depression, and anxiety. Supplementation with vitamin D improved MSP and associated disorders. .

Development of a Model with a Panel of Biochemical Parameters to Identify Major Depressive Disorder

Article

Full-text available

Jun 2018

Overfed but undernourished: recognizing nutritional inadequacies/deficiencies in patients with overweight or obesity

Article

Full-text available

Feb 2019
INT J OBESITY

Overweight and obesity are highly prevalent throughout the world and can adversely affect the nutritional status of individuals. Studies have shown that many people with obesity have inadequate intake of iron, calcium, magnesium, zinc, copper, folate and vitamins A and B12, likely as a result of poor diet quality. Nutritional inadequacies or deficiencies may also occur due to altered pharmacokinetics in the individual with obesity and due to interactions in those with overweight or obesity with various pharmaceuticals. However, it has been demonstrated that the adult population in the United States as a whole is deficient in certain micronutrients as a result of the availability and overconsumption of high-calorie, low-nutrient processed foods. Poor nutrition may contribute to the development of certain chronic conditions, such as type 2 diabetes, which is already more prevalent in those with obesity. Clinicians need to be aware of these gaps, particularly in those individuals with obesity who are undergoing bariatric surgery or taking pharmaceutical products long term to facilitate weight loss. Patients with overweight or obesity likely struggle to achieve a balanced diet and may benefit from consultation with a dietitian. Along with providing recommendations for healthy eating and exercise, supplementation with specific micronutrients or multivitamins should be considered for individuals at the highest risk for or with established deficiencies. Further research is needed to understand the factors underlying nutritional inadequacies in individuals with overweight or obesity, as well as the outcomes of treatment strategies employed to address them.

Study Protocol for a Randomized Double Blind, Placebo Controlled Trial Exploring the Effectiveness of a Micronutrient Formula in Improving Symptoms of Anxiety and Depression

Article

Full-text available

Jun 2018

Background: Anxiety and depression are conferring an increasing burden on society. Although treatments exist for both conditions, side effects, and difficulties accessing treatment prevent many people from receiving adequate assistance. Nutritional approaches have demonstrated some success in treating anxiety and depression. We plan to investigate whether a micronutrient formula, Daily Essential Nutrients, improves symptoms of anxiety and depression compared to a placebo in a community recruited sample. Methods: This will be a randomized, double blind placebo controlled study (RCT). Two hundred adults will be assigned to either a placebo or micronutrient group (placebo or Daily Essential Nutrients (DEN)) in a 1:1 ratio. Baseline data will be collected for 2 weeks, followed by 10 weeks of placebo or micronutrient intervention. Psychometrics will be used to measure progress and participant safety will be monitored weekly. Results: The primary outcome measures will be total scores on three measures of symptom severity at 10 weeks. Linear mixed modelling will be used to measure between group differences and effect sizes will be calculated using pooled mean scores and standard deviations over the course of the trial. Conclusions: If effective, micronutrients could provide an alternative treatment, with fewer barriers and adverse events than currently available treatments.

The Role of Micronutrients in Internalising Symptoms

Thesis

Full-text available

Nov 2016

Recent research suggests that diet quality and mental health are associated. However, the relationship between specific nutritional aspects of diet, such as micronutrient intake, and mental health still remain relatively unconfirmed. This thesis first provides a critical review of theoretical and empirical literature that has examined the role of micronutrients in internalising disorders. Overall, there is epidemiological evidence of an association between specific micronutrient deficiencies, such as zinc and folate, and depressive symptoms. However, evidence from studies examining other micronutrients, such as vitamin C or magnesium, have been tentative. In particular, there is less available evidence supporting an association between micronutrients and anxiety symptoms. In order to further investigate these relationships, a cross-sectional study was performed examining micronutrient intakes and internalising symptoms in undergraduate university students. Results from the study are presented in light of recent epidemiological research and current theoretical models.

Database Analysis of Depression and Anxiety in a Community Sample—Response to a Micronutrient Intervention

Article

Full-text available

Jan 2018

Background: Depression and anxiety are common mental health concerns worldwide. Broad-spectrum multi-vitamin/mineral approaches have been found to alleviate a number of psychiatric symptoms. We investigated the effects of a nutrient intervention program, which includes optimizing vitamin D levels, on depression and anxiety outcomes from community-based program. Methods: We evaluated self-reported health measures of depression and anxiety collected as part of a community-based program focused on optimizing overall health through nutritional supplementation, education and lifestyle advice. Results: Data were collected from 16,020 participants, with measures including European Quality of Life Five Dimensions (EQ-5D) and Targeted Symptoms List (TSL) providing self-reported depression and anxiety. More than 56% of participants were identified as having elevated levels of depression and anxiety at baseline as reported on the EQ-5D. After one year in the program, 49.2% (n = 7878) of participants who reported any level of depression or anxiety at baseline reported improvement at follow-up. Of those who reported severe/extreme depression at baseline (n = 829), 97.2% reported improvement after one year. Regression analyses revealed a significant association of improvement in depression and anxiety with higher vitamin D status (>100 nmol/L) and more strenuous physical activity. Conclusion: Overall, people from the general population who suffer from mood and anxiety problems may benefit from improved nutritional status achieved with nutritional supplements.

Micronutrient intake adequacy and depression risk in the SUN cohort study

Article

Full-text available

Oct 2018
EUR J NUTR

Purpose: The aim of the study was to prospectively assess the association between micronutrient intake adequacy and risk of depression. Methods: This dynamic cohort study involves Spanish university graduates (SUN Project). Dietary intake was assessed at baseline and after 10 years of follow-up with a semi-quantitative food frequency questionnaire. Micronutrient intake adequacy for vitamins B1, B2, B3, B6, B12, C, A, D, E, folic acid, zinc, iodine, selenium, iron, calcium, potassium, phosphorus, magnesium and chrome was estimated. Inadequate intake for each nutrient was defined when the intake of the nutrient was below the estimated average requirements (EAR) if available or the adequate intake levels, if EARs were not available. We compared participants with inadequate intake for ≥4 nutrients vs. those with one nutrient. Participants were classified as having incident depression if they had no previous history of depression or antidepressants use at baseline, but they reported during follow-up a new clinical diagnosis of depression by a physician, use of antidepressant drugs, or both. Time-dependent multivariable Cox regression models were fitted. Results: After a median follow-up of 8.5 years, 953 new cases of depression were observed among 13,983 participants. Participants with inadequate intake for ≥4 nutrients showed a significantly higher risk of depression [multivariable hazard ratio (HR) = 1.37; 95% confidence interval (CI) 1.01-1.85]. When the analyses were updated with repeated assessments of intakes, the association was attenuated and it was no longer statistically significant (Multivariable HR = 1.11; 95% CI 0.82-1.51). Conclusions: Micronutrient inadequacy in four or more micronutrients could exert a moderate role in the development of depression.

A Tale of Two Bivalent Cations in Major Depressive disorder

Article

Full-text available

Apr 2017

Effects of the single supplementation and multiple doses of Passiflora incarnata L. on human anxiety: A Clinical Trial, Double-blind, Placebo-controlled, Randomized

Article

Full-text available

Jan 2017

Object: This study aimed to investigate the effects of Passiflora incarnata L. on anxiety in humans. Method: The individuals were randomly assigned to one of the following groups: Placebo or experimental, n =30, single dose, as well as Placebo or Experimental, n =15, multiple dose. The experimental human anxiety was induced by simulated public speaking test in the following phases: Basal (B), stressful (A), speech 1 (S1), speech 2 (S2) and Final (F). We evaluated the Systolic Blood Pressure (SBP), and Diastolic (DBP), Heart Rate (HR), Electrical Conductance of Skin and extremities temperature (ET) and filled The state-trait anxiety inventory (STAI S e T). Results: During the single dose, the HR was reduced at the end of the speech (86±2,0 to 74±3,0 bpm) the experimental group compared to the placebo group (p

A double-blind trial of the effect of docosahexaenoic acid and vitamin and mineral supplementation on aggression, impulsivity, and stress

Article

Full-text available

Jan 2013
HUM PSYCHOPHARM CLIN

Sara Long

Objectives Although a series of well-designed studies have reported that supplementation with vitamins/minerals and omega-3 fatty acids reduces the incidence of aggressive behavior, to date, the relative contribution and interaction between these nutrients has not been examined. The aim was therefore to consider the relative contribution of supplementation with multivitamins/minerals and/or docosahexaenoic acid (DHA) on laboratory-based measures of aggression, impulsivity, and stress. Methods In a double-blind randomized trial, four groups of young adult men without a history of aggressive or impulsive behavior received a placebo (n = 42), multivitamins/minerals (n = 43), DHA (n = 47) or both (n = 41) for 3 months. Results With the Picture-Frustration Task, DHA decreased the display of aggressive behavior. DHA also decreased impulsivity as measured using the GoStop Impulsivity Paradigm that examines the ability to inhibit already initiated behavior. Although a multivitamin and mineral supplement did not influence these measures, it did decrease perceived stress. Conclusions The influence of supplementation on aggression and impulsivity can be conveniently studied in a sample without a history of antisocial behavior, using laboratory-based measures. No evidence was found of a synergistic interaction between vitamins/minerals and DHA.

Effect of Micronutrients on Insomnia in Adults: A Multiple-Baseline Study

Article

May 2016

Insomnia is a debilitating condition causing psychological distress and frequently comorbid with other mental health conditions. This study examined the effect of 8 weeks of treatment by broad spectrum micronutrients (vitamins and minerals) on insomnia using a multiple-baseline-across-participants open-label trial design. Seventeen adults were randomized to 1-, 2-, or 3-week baseline periods (14 completed). Self-report measures were the Consensus Sleep Diary–Morning (CSD-M), the Pittsburgh Insomnia Rating Scale (PIRS), and the Depression, Anxiety, Stress Scale (DASS). Baselines were generally stable. Treatment completers reported reliable and clinically significant change in insomnia severity (PIRS), in depression, stress, and anxiety (DASS), and on at least two aspects of sleep measured by the CDS-M. All completers were treatment-compliant, and side effects were minimal. Nutritional supplementation is shown to be a novel, beneficial treatment for insomnia in adults. Follow-up research using placebo-controlled designs as well as comparisons to cognitive-behavioral and other treatments is recommended.

Nutritional interventions for the prevention and treatment of neurological disorders such as anxiety, bipolar disorder, depression, epilepsy, multiple sclerosis, and schizophrenia

Article

Full-text available

Nov 2022

Neurological disorders are a significant cause of mortality and disability across the world. The current aging population and population expansion have seen an increase in the prevalence of neurological and psychiatric disorders such as anxiety, bipolar disorder, depression, epilepsy, multiple sclerosis and schizophrenia. These pose a significant societal burden, especially in low - and middle-income countries. Many neurological disorders have complex mechanisms and lack definitive cures; thus, improving our understanding of them is essential. The pathophysiology of neurological disorders often includes inflammation, mitochondrial dysfunction and oxidative stress. Oxidative stress processes, especially the generation of reactive oxygen species, are key mechanisms in the development of neurological disorders. Oxidative stress refers to an imbalance between the production of reactive oxygen species and antioxidants that can counteract them. Through their impacts on the pathophysiology of neurological disorders, nutrients with anti-inflammatory, neuroprotective and antioxidative properties have been suggested to prevent or mitigate these disorders. Certain vitamins, minerals, polyphenols and flavonoids may have therapeutic effects as adjuvant treatments for neurological disorders. Diet quality is also a risk factor for some neurological and psychiatric disorders and addressing nutritional deficiencies may alleviate symptoms. Therefore, optimizing nutritional intake may represent a potential treatment or prevention strategy. This review summarizes a selection of promising nutrients for the prevention and amelioration of neurological disorders to provide a summary for scientists, clinicians and patients, which may improve understanding of the potential benefits of nutrients in the treatment of neurological disorders.

Nutrition Bio Shield (NBS) supplement effects on depression, anxiety, stress and food craving in women with depression and obesity: a double-blind randomized controlled trial

Article

Sep 2022
Nutr Food Sci

Purpose Nutrition Bio Shield (NBS) supplement is a natural product that is processed from whole wheat grains. This study aims to determine its effects on depression, anxiety, stress and food craving in women with depression and obesity in a double-blind randomized clinical trial. Design/methodology/approach Fifty-six eligible clients with body mass index ≥ 25 and mild or moderate depression signed the informed consent form. They were randomly assigned to receive daily 5 g of NBS or placebo. The assessments included the depression, anxiety and stress-21 questionnaire, food craving questionnaire, visual analogue scale for appetite, precise anthropometric measurements and body composition analyses. The assessments were conducted at the baseline and repeated after four and eight weeks. One month after the study completion, the participants’ weight was assessed. The authors analyzed the data by independent sample t -test, repeated measures analysis of variance and multivariate analyses of covariance (MANCOVA). Findings At the baseline, no significant differences were observed between the groups regarding the main and demographic variables. After four weeks, stress reduced significantly in the NBS group ( p = 0.04), and after eight weeks, anxiety ( p = 0.02), stress ( p = 0.008) and food craving ( p = 0.05) reduced significantly in the NBS group compared with the placebo. After controlling for the demographic variables and baseline measurements, MANCOVA model revealed a significant effect of NBS in reducing anxiety (Eta-squared = 0.28; p = 0.001) and stress (Eta-squared = 0.19; p = 0.009). Fisher’s exact test showed no significant difference regarding side effects between NBS and placebo ( p = 0.47). Originality/value NBS supplement is a patent and natural product that is processed from whole wheat grains. This product was efficient in reducing stress and anxiety after controlling for demographic variables and baseline measurements compared with the placebo and was safe.

Behaviors observed in different live species depending on nutrition

Article

Full-text available

Aug 2022

In order for living species to have a healthy and balanced diet, their needs for adequate amounts of protein, oil, carbohydrates, vitamins and minerals must be met. When the amount of nutrients required by the living species is not taken as much as necessary, various health problems such as psychological, as well as metabolic, physiological and chemical disorders occur. One of the fundamental indicators of psychological problems is the diet of the living thing. Excess or less of the amount of nutrients required by the living species can cause various behavioral disorders. When these behavioral disorders are examined; chronic anxiety, nervous tension and insomnia, mood and depressive symptoms, counterconditioning and depersonalization, behavioral disorders, cognitive performance and anxiety, social interaction capacity, locomotor activity, repetitive behaviors, motor coordination and seizure sensitivity, autism spectrum disorder, alzheimer's, antiepileptic it is stated in studies that it has a characteristic feature and effects on manic type bipolar disorder and migraine headache. Moreover; it is stated that the secretion of the stress hormone cortisol, social and communication disorders and restricted/repetitive behaviors, heterogeneous neurodevelopmental disorders, satiety, performance restriction, chewing behavior, stereotypical behaviors affect animal welfare, yield and performance closely. In this study, it is aimed to give information about the abnormal behaviors observed in different species depending on nutrition.

Nutrient deficiency profiles and depression: A latent class analysis study of American population

Article

Aug 2022
J AFFECT DISORDERS

Background Research into the effects of nutrition on depression is often performed by examining the effects of singular nutrients and dietary styles (e.g.: vegan, Mediterranean). The present study is the first one to establish the effects of patterns of nutritional deficiency within the American population and examines their effects on depression. Methods Data was drawn from National Health and Nutrition Examination Survey (NHANES). Latent class analysis was performed to identify homogeneous groups of nutrient deficiency. A 3-step analysis was performed to establish class-dependant differences in depression severity. BCH analysis revealed unique predictors of depression dependant on most probable class. Results Analysis revealed 4 classes of nutrient deficiency. Magnesium and dietary fibre were the least endorsed. ‘Nutrient deprived’ individuals showed the highest depression severity (Mean = 4.137, SD = 0.337). Profiles were predicted by different socioeconomic and anthropogenic predictors with meeting minimum calories showing the strongest odds of not being nutrient deprived (OR between 5.44 and 11.11). Overall, age (β = −0.115, p ≤ 0.01) and income (β = −0.147, p ≤ 0.01) were the strongest protecting factors while being female (β = 0.128, p ≤ 0.01) and arthritis (β = 0.130, p ≤ 0.01) were the strongest risk factors. Limitations The study involved binary variables based on minimum daily intakes and did not account for positive effects of exceeding minimum recommended doses. Conclusions The study supports the notion of a negative relationship between good nutrition and depression. Finding unique risk factors for depression symptoms supports the utility of nutrient deficiency profiling.

Potential mental and physical benefits of supplementation with a high-dose, B-complex multivitamin/mineral supplement: What is the evidence?

Article

Sep 2021

Objective: to perform a systematic literature review to examine the effects of high-dose, B-complex multivitamin/mineral supplementation on physical, mental, and energy outcomes in healthy and 'at-risk' (suboptimal nutritional status/subclinical symptoms at baseline) adult populations. Methods: PubMed was searched for relevant randomized controlled trials until January 2020. Results: overall, 136 publications were identified. In the seven randomised, double-blind, placebo-controlled studies considered eligible for inclusion, supplementation in healthy populations predominantly showed improvements in perceived stress, physical stamina, concentration, and general mental health, and significant reductions in anxiety and improvements in self-reported vigour. However, not all of these outcomes were significant, and statistical correction for multiple outcomes was not commonly employed. Studies investigating brain mapping following supplementation indicated increased functional activity in brain regions related to processing of attention, executive control, and working memory during cognitive tasks. Conclusions: while there is certainly a need for further studies on the neurocognitive and physical benefits of micronutrient supplementation, this review provides generally supportive evidence for the benefits of a high-dose, B-complex multivitamin/mineral supplement in healthy and at-risk populations in terms of physical, mental, and energy outcomes.

Desenvolvimento de cartilha sobre os benefícios da alimentação para reduzir a ansiedade em tempos de COVID-19: Relato de experiência

Article

Full-text available

Jul 2021

Este artigo possui como objetivo relatar o desenvolvimento de uma cartilha sobre os benefícios da alimentação para reduzir a ansiedade em tempos de COVID-19. O desenvolvimento do material foi realizado por discentes e docentes da Faculdade de Ciências da Saúde do Trairi e do Departamento de Fisiologia e Comportamento, ambos pertencentes à Universidade Federal do Rio Grande do Norte. O material pretendeu abranger a comunidade acadêmica e não acadêmica. As pesquisas que fundamentaram o conteúdo da cartilha foram realizadas nas bases de dados Pubmed, Science Direct, Scopus, Lilacs e PsycINFO e o material foi dividido em três seções. A cartilha foi finalizada e compartilhada no mês de abril de 2020, em formato pdf, e possui 18 páginas. A linguagem utilizada foi coloquial, e partes do texto estão na voz ativa. O projeto de extensão universitária aqui relatado possivelmente auxiliou na promoção da saúde nesse período de pandemia, pois facilitou a disseminação de conhecimentos para a população. Nesse sentido, em tempos de pandemia, ações de extensão realizadas através do desenvolvimento de cartilhas podem ser consideradas uma estratégia benéfica, segura e acessível para a população. Palavras-chave: Saúde Mental; Transtornos de Ansiedade; Coronavírus; Dieta Development of a booklet on the benefits of food to reduce anxiety in times of COVID-19: Experience report Abstract: his article aimed to report the development of a booklet on food benefits to reduce anxiety in times of COVID-19. Students and professors carried out the development of the material at the Faculty of Health Sciences of Trairi and the Department of Physiology and Behavior, both belonging to the Federal University of Rio Grande do Norte, Brazil. The material was intended to reach the academic and non-academic communities. The research that substantiated the booklet's content was obtained in the databases Pubmed, Science Direct, Scopus, Lilacs, and PsycINFO, and the material was divided into three sections. The booklet was finalized and shared in April 2020, is in pdf format with 18 pages. The language used was colloquial, and parts of the text are in the active voice. The university extension project reported here possibly helped promote health in this pandemic period, as it facilitated disseminating knowledge to the population. In this sense, in times of pandemic, extension actions carried out through the development of booklets can be considered a beneficial, safe, and accessible strategy for the population. Keywords: Mental Health; Anxiety Disorders; Coronavirus; Diet

Nutraceuticals in anxiety and stress

Chapter

Jan 2021

Anxiety is a very prevalent mental disorder. γ-Aminobutyric acid (GABA) is the main inhibitory neurotransmitter in the mammalian brain and many anxiolytic drugs exert their action through interactions with the GABA receptors. In addition to the GABAergic system, serotonergic, dopaminergic, and noradrenergic systems are also implicated in the development of anxiety and stress in various animal models and humans. Furthermore, involvement of the hypothalamic–pituitary–adrenal axis and dysregulation of the immune system may also mediate stress and anxiety in humans and animals. While a number of anxiolytic drugs are available on the market, dietary supplements and herbal extracts are shown to exert equivalent calming effects with minimal to no addictive or adverse side effects. This chapter describes the pharmacological targets involved in the development of stress and anxiety and the role of various nutraceuticals and dietary supplements that have the potential to reduce anxiety and stress.

Systematic and Critical Evaluation of Benefits and Possible Risks of Nutritional Ergogenic Aids

Chapter

Jun 2004

Effect of Magnesium Supplementation on Mental Health in Elderly Subjects with Insomnia: a Double-blind Randomized Clinical Trial

Article

Full-text available

Oct 2013

Objectives: The objective of this study was to determine the effects of dietary magnesium supplementation on mental health in elderly individuals with insomnia. Method: A double-blind randomized clinical trial was conducted on 46 elderly subjects with insomnia randomly allocated to the magnesium or placebo (control) group. The groups received either 500 mg elemental magnesium or placebo, respectively, daily for eight weeks. General Health Questionnaire-28 (GHQ-28) and Insomnia Severity Index (ISI) were conducted at baseline and at the end of the intervention period. Serum magnesium and cortisol levels were also determined in the participants. In addition, information was obtained on anthropometric confounding factors and daily intake of magnesium, calcium, potassium and caffeine using the 24-hour Recall Questionnaire. The "Nutritionist 4" software was used for nutritional analysis. Statistical analysis was done using paired t-test to compare within-groups differences and Student's t-test to compare between-groups differences. Results: No significant differences were observed in the assessed variables between groups at baseline. Compared to the placebo group, dietary magnesium supplementation in the experimental group brought about statistically significant decreases in total GHQ-28 score (p=0.01), somatic symptoms (p=0.04), anxiety/insomnia symptoms (p=0.02), depression symptoms (p=0.001), Insomnia Severity Index (p=0.006), and serum cortisol concentration (p=0.008). Conclusion: Magnesium supplementation can affect some indices of mental health and insomnia and may hence result in improvements in general mental health in elderly people with insomnia.

Vitamins, Cognition, and Mood in Healthy Nonelderly Adults

Chapter

Jan 2013

Nutraceuticals for Calming and Stress

Chapter

May 2019

Stress in animals is evident through the disruptive behaviors exhibited, including excessive barking, restlessness, repetitive behavior, extreme vigilance, etc. Sociability is a key factor in determining the successful adaptation of pets to their environment. Sociable dogs are more comfortable with strangers and unfamiliar situations. Thus, reducing stress and anxiety in pets is essential in providing positive social interactions and to improve the quality of their life and that of the owners. γ-Aminobutyric acid (GABA) is the main inhibitory neurotransmitter in the mammalian brain, and many anxiolytic drugs exert their action through interactions with the GABA receptors. In addition to the GABAergic system, serotonergic, dopaminergic, and noradrenergic systems are also implicated in the development of anxiety and stress in various animal models and in humans. Furthermore, the involvement of the hypothalamic-pituitary-adrenal (HPA) axis and dysregulation of the immune system may also mediate social stress in animals that produces aggression and/or depression. While a number of anxiolytic drugs are available on the market, dietary supplements and herbal extracts are shown to exert equivalent calming effects with no or minimal addictive or aversive side effects. This chapter describes the underlying mechanisms involved in the development of stress and anxiety and various nutraceuticals and substances that have potential to reduce the stress behavior and improve social interactions in canines.

Ergogenics: Maintaining Performance During Physical Stress

Chapter

Jan 2006

Luke Robert Bucci

This chapter will briefly describe which sports nutrition and dietary supplement products work and which do not work for enhancing physical performance. Physical activities require expenditure of metabolic energy over that required for existence. Desire to perform physical tasks better is a common human trait, especially in competitive sports.

Yeast based spreads improve anxiety and stress

Article

Jan 2018

Yeast based spreads (YBS) such as marmite and vegemite, made from leftover brewer’s yeast extract are one of the world’s richest source of B vitamins. We evaluated symptoms of depression, anxiety, stress scores (DASS) in participants who consume or do not consume YBS. 520 participants completed a survey consisting of 70–94 questions relating to the consumption of YBS, dietary and lifestyle habits and mood symptoms of DASS. Parametric analysis co-varying for gender, diet, supplement use, soy milk and alcohol consumption and history of psychiatric disorders including depression and anxiety were utilized to analyse the results. A significant improvement was noted in anxiety and stress but not depressive symptoms in those consuming YBS. Furthermore, those who consumed vitamin B12 fortified YBS showed even greater improvement in stress symptomology. Vitamin B supplementation appears to be an important additive supplementary source to improved stress and anxiety in the general adult population.

Purified Dry Paullinia cupana (PC-18) Extract for Chemotherapy-Induced Fatigue: Results of Two Double-Blind Randomized Clinical Trials

Article

Nov 2017

Fatigue is frequent among oncologic patients. Unpurified Paullinia cupana dry extract showed encouraging results for chemotherapy-induced fatigue in our previous studies. We report two randomized, double-blind studies with a standardized dry purified Paullinia cupana extract named PC-18. For both studies, we recruited early breast cancer patients who had an increase in their fatigue scores after their first cycle of adjuvant chemotherapy. In the first study, we compared an oral dose of 37.5 mg of PC-18 twice daily with placebo. In the second study, we examined PC-18 at either 7.5 or 12.5 mg orally twice daily versus placebo. In both studies, PC-18 was not superior to placebo as assessed by both Chalder and Brief Fatigue Inventory (BFI) fatigue questionnaires, probably reflecting unexpectedly good placebo antifatigue activity. Since all capsules employed in both studies contained about 100 mg of magnesium silicate as an excipient, we retrospectively evaluated frozen serum samples from the second study and found a significant increase in magnesium levels after patients received placebo. By multivariate analysis, higher prerandomization magnesium levels and higher BFI scores together with the use of a 12.5 mg dose of PC-18 all correlated significantly with higher posttreatment BFI scores. We observed no significant toxicities in any of the trials. We conclude that the absence of differences between PC-18 and placebo may be due to the unexpectedly high antifatigue activity of the placebo in these studies. Further studies evaluating the role of magnesium supplementation for chemotherapy-induced fatigue are needed.

Nutritional-Based Nutraceuticals in the Treatment of Anxiety

Chapter

Dec 2017

David A. Camfield

This chapter will present evidence from human clinical trials regarding the efficacy of nutritional supplements which have emerged in recent years as viable treatments for anxiety disorders. B vitamins Magnesium Lysine and Arginine Myo-Inositol N-Acetyl-cysteine

The effect of nutrients on mood

Article

Full-text available

Sep 1999

A recent major theory was that a meal high in carbohydrate increased the rate that tryptophan enters the brain, leading to an increase in the level of the neurotransmitter serotonin that modulates mood. Although such a mechanism may be important under laboratory conditions it is unlikely to be of significance following the eating of any typical meal. As little as 2-4% of the calories of a meal as protein will prevent an increased availability of tryptophan. Arguably the food with the greatest impact on mood is chocolate. Those who crave chocolate tend to do so when they feel emotionally low. There have been a series of suggestions that chocolate's mood elevating properties reflect 'drug-like' constituents including anandamines, caffeine, phenylethylamine and magnesium. However, the levels of these substances are so low as to preclude such influences. As all palatable foods stimulate endorphin release in the brain this is the most likely mechanism to account for the elevation of mood. A deficiency of many vitamins is associated with psychological symptoms. In some elderly patients folate deficiency is associated with depression. In four double-blind studies an improvement in thiamine status was associated with improved mood. Iron deficiency anaemia is common, particularly in women, and is associated with apathy, depression and rapid fatigue when exercising.

Food supplement usage in seven Western states

Article

Full-text available

Dec 1982

Data on food supplement usage were collected from 2451 adults in seven Western states. No significant differences were determined among states. A majority (66.6%) of the sample used some form of food supplements, with 40.0% consuming one to three supplements per day. The archetype food supplement user was likely to be a young female with some college education, who believes that the nutritional quality of food has decreased in the last 10 yr and in the efficacy of supplements for disease prevention or cure, and primarily receives information concerning food and nutrition from books and health food stores. Correspondingly, one of the most frequently cited reasons for using food supplements, next to "to prevent colds and other illnesses" was "to make up for what is not in food." The three most frequently used food supplements, in rank order, were multiple vitamins, vitamin C, and multiple vitamins plus iron.

Vitamin C and the Common Cold: A retrospective analysis of Chalmers review

Article

Full-text available

May 1995

In 1975 Thomas Chalmers analyzed the possible effect of vitamin C on the common cold by calculating the average difference in the duration of cold episodes in vitamin C and control groups in seven placebo-controlled studies. He found that episodes were 0.11 +/- 0.24 (SE) days shorter in the vitamin C groups and concluded that there was no valid evidence to indicate that vitamin C is beneficial in the treatment of the common cold. Chalmers' review has been extensively cited in scientific articles and monographs. However, other reviewers have concluded that vitamin C significantly alleviates the symptoms of the common cold. A careful analysis of Chalmers' review reveals serious shortcomings. For example, Chalmers did not consider the amount of vitamin C used in the studies and included in his meta-analysis was a study in which only 0.025-0.05 g/day of vitamin C was administered to the test subjects. For some studies Chalmers used values that are inconsistent with the original published results. Using data from the same studies, we calculated that vitamin C (1-6 g/day) decreased the duration of the cold episodes by 0.93 +/- 0.22 (SE) days; the relative decrease in the episode duration was 21%. The current notion that vitamin C has no effect on the common cold seems to be based in large part on a faulty review written two decades ago.

Does Multivitamin Supplementation Prevent Infections in Healthy Elderly Subjects? A Controlled trial

Article

Full-text available

Jan 1993

We performed a double blind randomized study in order to assess the efficacy of a multivitamin supplement for the prevention of common infections in healthy elderly subjects. Non-institutionalized, independent subjects over 60 years of age, living in the Nevers area (central France) were recruited by announcements and randomly assigned to a treatment or a placebo group. The treatment or placebo tablets were to be taken daily for 4 months. The principal criterion of response was the incidence of infections, as recorded from a detailed questionnaire presented at entrance, in the middle (2 months) and at the end (4 months) of the study. Blood samples were taken at the entrance in the study and after two and four months in order to monitor vitamin status. No significant difference was found between the two groups for the incidence of infections. In fact the observed incidences during the two two-month periods were higher in the treatment (0.38 and 0.21) than in the placebo group (0.29 and 0.13). After two months and after four months of supplementation, blood vitamin indicators of the subjects were significantly higher in the treatment than in the placebo group for vitamins B1, B2, B6, E and folates (p < 0.001). The improvement of the vitamin C status was slightly higher in the treatment than in the placebo group. For vitamin A status, the evolution was similar in the two groups. In conclusion, short-term supplementation of healthy elderly subjects with the investigated supplement is not likely to afford a meaningful protection against common infections.

Use of Vitamin and Mineral Supplements by Pharmacy Students

Article

Full-text available

May 1993
Am J Hosp Pharm

Use of vitamin and mineral supplements by undergraduate pharmacy students and the students' perceptions and beliefs about these products were studied. Undergraduate pharmacy students from two schools in Philadelphia completed a questionnaire in which they were asked whether they had taken vitamin or mineral supplements within the preceding two weeks, the reason for taking the supplements, and the identity of the type of products taken. General demographic information and a self-assessment of health and diet were also obtained. In addition, using a five-point Likert scale, students were asked to rate the degree to which they agreed with five controversial statements regarding vitamin and mineral supplements. Of the 692 students completing the questionnaire, 47% had taken supplements in the preceding two weeks. This percentage is higher than that determined in surveys of the general population and of professionals in other health disciplines. No significant difference was noted in the percentage of men and women who took supplements, but the types of products taken by men and women differed significantly. The most common reasons for taking supplements were inadequate diet, to improve energy, for stress, and for colds. Year in school had a modest influence on the beliefs about vitamin and mineral supplement use expressed by students. The use of vitamin and mineral supplements among pharmacy students was high. Pharmacy schools should devote time in the curriculum to the sociological and clinical aspects of vitamin and mineral therapy.

Vitamin C intake and susceptibility to the common cold

Article

Full-text available

Feb 1997

Harri Hemilä

Although the role of vitamin C in common cold incidence had been studied extensively, the level of vitamin C intake has not been unequivocally shown to affect the incidence of colds. In the present study the six largest vitamin C supplementation (> or = 1 g/d) studies, including over 5000 episodes in all, have been analysed, and it is shown that common cold incidence is not reduced in the vitamin C-supplemented groups compared with the placebo groups (pooled rate ratio (RR) 0.99; 95% CI 0.93, 1.04). Consequently these six major studies give no evidence that high-dose vitamin C supplementation decreases common cold incidence in ordinary people. Nevertheless, the analysis was continued with the hypothesis that vitamin C intake may affect common cold susceptibility in specific groups of people. It was assumed that the potential effect of supplementation might be most conspicuous in subjects with low dietary vitamin C intake. The average vitamin C intake has been rather low in the UK and plasma vitamin C concentrations are in general lower in males than in females. In four studies with British females vitamin C supplementation had no marked effect on common cold incidence (pooled RR 0.95; 95% CI 0.86, 1.04). However, in four studies with British male schoolchildren and students a statistically highly significant reduction in common cold incidence was found in groups supplemented with vitamin C (pooled RR 0.70; 95% CI 0.60, 0.81). Thus, these studies with British males indicate that vitamin C intake has physiological effects on susceptibility to common cold infections, although the effect seems quantitatively meaningful only in limited groups of people and is not very large.

An open non-comparative study on the efficacy of an oral multivitamin combination containing calcium and magnesium on persons permanently exposed to occupational stress-predisposing factors

Article

Jan 1998

This open non-comparative study assessed the effects of 30 consecutive days treatment with Berocca® on the psychological and physical well-being of subjects (n = 307), aged 18-52 years, permanently exposed to factors predisposing to occupational stress. Compared with baseline, self-reported total SAN score (+32.2) and subscales for 'fitness' (+11.9), 'activity' (+8.8) and 'mood' (+9.5) increased significantly (p < 0.001 in each case) by the end of treatment. Subgroup analysis for sex, age (18-34 and 35-52 years) and different predisposition to stress confirmed these improvements (p < 0.001 in each case). Increased 'fitness' was significantly (p = 0.021) greater for females (+13.4) than males (+11.0). Improved 'mood' was statistically greater for subjects with low exposure than those with medium (p = 0.033) or high (p = 0.016) exposure to stress. Only 5 adverse events (i.e. mild diarrhoea in 2 and moderate pyrosis in 3 cases) were considered as possibly related to study medication. Multivitamins in combination with calcium and magnesium were well tolerated and were associated with the allevation of symptoms observed in occupational stress.

Vitamin C Supplementation and Common Cold Symptoms: Problems with Inaccurate Reviews

Article

Nov 1996
NUTRITION

H. Hemila

In 1971, Linus Pauling carried out a meta-analysis of four placebo-controlled trials and concluded that it was highly unlikely that the decrease in the ''integrated morbidity of the common cold'' in vitamin C groups was caused by chance alone (P < 0.00003). Studies carried out since then have consistently found that vitamin C (greater than or equal to 1 g/d) alleviates common cold symptoms, indicating that the vitamin does indeed have physiologic effects on colds. However, widespread conviction that the vitamin has no proven effects on the common cold still remains. Three of the most influential reviews drawing this conclusion are considered in the present article. Two of them are cited in the current edition of the RDA nutritional recommendations as evidence that vitamin C is ineffective against colds. In this article, these three reviews are shown to contain serious inaccuracies and shortcomings, making them unreliable sources on the topic. The second purpose is to suggest possible conceptual reasons for the persistent resistance to the notion that vitamin C might have effects on colds. Although placebo-controlled trials have shown that Vitamin C does alleviate common cold symptoms, important questions still remain. (C) Elsevier Science Inc.

A survey of pharmacists' recommendations for food supplements in the USA and UK

Article

Apr 1990
J CLIN PHARM THER

A survey was sent to 1,000 pharmacists in metropolitan Detroit U.S.A. (19.7% responded) and 750 pharmacists in the U.K. (57.9% responded) to assess the frequency of recommendations for health food stores, minerals, multivitamins, natural vitamins, protein supplements, Stresstabs®, and weight-reduction products. Pharmacists were also asked about their five most common reasons for recommending vitamins and minerals from a list of 16 items, which included alcoholism, anaemia, arthritis, athletically active, children, colds, dieting, fatigue, feeling nervous, headaches, old age, pain, pregnancy, prophylaxis, skin problems, stress or other. About 40% of the U.S.A. community pharmacists recommended multivitamins more than five times a week compared to 28-6% of U.K. community pharmacists. Anaemia (48.6%), dieting (44.8%), alcoholism (42.3%), pregnancy (400%), and fatigue (36.8%) were the five most common reasons for pharmacists to recommend vitamins and minerals, this was consistent, for the most part, with the American Medical Association's Council on Scientific Affairs report, however, a large number of pharmacists placed the non-specific symptoms of fatigue and stress in the five most common reasons for which they recommend vitamins or minerals.

Stress, hassles and variations in alcohol consumption, food choice and physical exercise: A diary study

Article

Feb 1998

Objectives. To assess the impact of daily life-stress on behaviours (alcohol consumption, food choice and physical exercise) that influence health risk. Method. Twenty-three nurses and 21 teachers completed daily assessments of mood, alcohol and food intake, together with weekly measures of hassles, perceived stress, anxiety, depression and exercise behaviour, over an eight-week period. Comparisons were made between the two highest and two lowest perceived stress weeks. Results. Work and home-related hassles were more frequent on high than low stress weeks, and anxiety and depression levels were greater, even after controlling for negative affectivity. Participants who drank alcohol to cope showed increases in consumption between low and high stress weeks. ‘Fast food’ was eaten more frequently during high stress weeks. People who reported that mood control was an important influence on their choice of food showed increases in the amount of cheese they ate, and greater consumption of sweet foods. There were no differences in exercise frequency or duration with changes in perceived stress. Conclusions. Diary studies allow changes in health behaviour with life-stress to be assessed naturalistically. The impact of stress depends on the moderating effects of motives and coping expectancies associated with specific behavioural domains. Some responses may be prejudicial to long-term health risk.

The Hospital Anxiety And Depression Scale

Article

Jun 1983
ACTA PSYCHIAT SCAND

ABSTRACT– A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.

A trial of ascorbic acid in the treatment of the common cold

Article

Oct 1977
Br J Prev Soc Med

A randomised controlled trial was carried out to study the effect of 10 g of ascorbic acid taken during the first 2 1/2 days on the symptoms of the common cold. Altogether 1524 volunteers were recruited from a number of working groups in different parts of the country; 482 developed colds. There was no evidence that upper respiratory or general constitutional symptoms were alleviated by ascorbic acid. Among the men who had any colds at all, significantly fewer on active than on placebo treatment had two or more colds; however, this effect was not seen in women. Ascorbic acid is of no value in the treatment of the common cold; its preventive effect, if any, is not such as to justify advising its general use as a prophylactic measure.

A Scaled Version of the General Health Questionnaire

Article

Mar 1979

SYNOPSIS This study reports the factor structure of the symptoms comprising the General Health Questionnaire when it is completed in a primary care setting. A shorter, 28-item GHQ is proposed consisting of 4 subscales: somatic symptoms, anxiety and insomnia, social dysfunction and severe depression. Preliminary data concerning the validity of these scales are presented, and the performance of the whole 28-item questionnaire as a screening test is evaluated. The factor structure of the symptomatology is found to be very similar for 3 independent sets of data.

Serum folic acid and B12 in 272 psychiatric in-patients

Article

Mar 1978

Synopsis Serum folate and B12 estimations were carried out on 272 admissions to a psychiatric unit during 1972 and 1973. 21–3% had serum folate below 2 ng/ml and 26–1% serum B12 below 150 pg/ml. The organic psychosis patients had a significantly lower mean B12 than the others, and were over-represented among the low B12 group. Low B12 status was also associated with low RBC and WBC. Low folate status was linked with depression, malnutrition, physical illness and low Hb, RBC and WBC. There were more chronic alcoholics than others with serum folate > 4·9 ng/ml, low RBC and macrocytosis. The presence of one or more haematological abnormalities (macrocytosis, low Hb, low RBC or low WBC) predicted low folate in 76%, and low B12 in 79%, but these were also found in 40% of the normal folate and 41% of the normal B12 patients. Macrocytosis may prove to be a reliable sign of alcoholic abuse.

Marmot MG, Davey Smith G, Stansfeld S, Patel C, North F, Head J, White I, Brunner E, Feeney A. Health inequalities among British civil servants: the Whitehall II study

Article

Jul 1991

The Whitehall study of British civil servants begun in 1967, showed a steep inverse association between social class, as assessed by grade of employment, and mortality from a wide range of diseases. Between 1985 and 1988 we investigated the degree and causes of the social gradient in morbidity in a new cohort of 10,314 civil servants (6900 men, 3414 women) aged 35-55 (the Whitehall II study). Participants were asked to answer a self-administered questionnaire and attend a screening examination. In the 20 years separating the two studies there has been no diminution in social class difference in morbidity: we found an inverse association between employment grade and prevalence of angina, electrocardiogram evidence of ischaemia, and symptoms of chronic bronchitis. Self-perceived health status and symptoms were worse in subjects in lower status jobs. There were clear employment-grade differences in health-risk behaviours including smoking, diet, and exercise, in economic circumstances, in possible effects of early-life environment as reflected by height, in social circumstances at work (eg, monotonous work characterised by low control and low satisfaction), and in social supports. Healthy behaviours should be encouraged across the whole of society; more attention should be paid to the social environments, job design, and the consequences of income inequality.

The factor Structure and Fator Stability of the Hospital Anxiety and Depression Scale in Pacients With Cancer

Article

Mar 1991

An exploratory factor analysis of the HAD was carried out in 568 cancer patients. Two distinct, but correlated, factors emerged which corresponded to the questionnaire's anxiety and depression subscales. The factor structure proved stable when subsamples of the total sample were investigated. The internal consistency of the two subscales was also high. These results provide support for the use of the separate subscales of the HAD in studies of emotional disturbance in cancer patients.

Vitamin Use and Beliefs Among Students at a Malaysian University

Article

Sep 1990
J Roy Soc Health

Mazlan Bin Yong

QUESTIONNAIRE was administered in class to a sample of physical education students at a Malaysian University in order to determine their beliefs and use patterns regarding vitamin supplemen tation. About a quarter of the subjects (24.6%) had practised vitamin supplementation for the past two years prior to the study, 14.9% of them being females as opposed to only 9.7% males. The most frequently used vitamin supplements, in rank order, were multivi tamins (used by 57.6%), vitamin C (24.2%), the B-Complex vitamins (9.1%), and vitamin E (6.1%). Among vitamin supplementeers, the most frequently cited reasons for using vitamin supplements, in rank order, were 'to supplement the daily diet' (33.3%), 'to prevent colds' (27.3%), and 'to prevent fatigue or lethargy' (21.2%). Among non-supplementeers, the three reasons most frequently mentioned for not using vitamin supplements were 'vitamin needs are ade quately supplied by daily meals' (50.5%), 'I am healthy enough and therefore I do not need extra vitamins' (27.2%), and 'fear of insidious side effects' (9.9%). In general, both supplementeers and non-supple menteers tended to beheve in the purported health benefits of vitamin supplementation. However, on the whole, supplementeers were willing to change their supplementation habits.

Vitamin/Mineral Supplement Use Among General Practice Patients in the United Kingdom

Article

Oct 1990

Many patients take vitamin/mineral supplements, sometimes in doses which may cause toxicity. A survey of 186 patients in one general practice showed that 44% consumed supplements; almost half of these took them daily, and over half had taken them for longer than a year. Younger patients were more likely to take vitamins than older ones. Multivitamins were the most frequently used supplement, followed by iron and vitamin C. Major reasons patients cited for supplement use were to ensure good nutrition, to prevent illness, and for tiredness/fatigue. Patients were most influenced in their decision to take vitamins by family and friends rather than by doctors. General practitioners may find it valuable to include questions about vitamin/mineral supplement use in the medical history.

A survey of pharmacists recommendations for food supplements in the U.S.A. and U.K

Article

May 1990

A survey was sent to 1,000 pharmacists in metropolitan Detroit U.S.A. (19.7% responded) and 750 pharmacists in the U.K. (57.9% responded) to assess the frequency of recommendations for health food stores, minerals, multivitamins, natural vitamins, protein supplements, Stresstabs, and weight-reduction products. Pharmacists were also asked about their five most common reasons for recommending vitamins and minerals from a list of 16 items, which included alcoholism, anaemia, arthritis, athletically active, children, colds, dieting, fatigue, feeling nervous, headaches, old age, pain, pregnancy, prophylaxis, skin problems, stress or other. About 40% of the U.S.A. community pharmacists recommended multivitamins more than five times a week compared to 28.6% of U.K. community pharmacists. Anaemia (48.6%), dieting (44.8%), alcoholism (42.3%), pregnancy (40.0%), and fatigue (36.8%) were the five most common reasons for pharmacists to recommend vitamins and minerals, this was consistent, for the most part, with the American Medical Association's Council on Scientific Affairs report, however, a large number of pharmacists placed the non-specific symptoms of fatigue and stress in the five most common reasons for which they recommend vitamins or minerals.

Nutritional supplement use by patients in a rural family practice

Article

Feb 1986

The use of nutritional supplements (vitamins, minerals) has been reported to be as high as 66% for individuals and 54% for households. Among medical patients in metropolitan areas, 66% of suburban private patients and 31% of urban clinic patients use supplements. Reported here are results of a survey to assess the use of nutritional supplements by rural family medicine patients. A sample of patients (N = 199) in one practice completed a standardized questionnaire, and 54% reported that they had taken supplements (primarily multivitamins) during the previous 6 months. The desire to assure good nutrition and less fatigue were the major reasons cited for supplement use; 50% were daily users, and 42% had used supplements for longer than 3 years.

A Global Measure of Perceived Stress

Article

Jan 1984

This paper presents evidence from three samples, two of college students and one of participants in a community smoking-cessation program, for the reliability and validity of a 14-item instrument, the Perceived Stress Scale (PSS), designed to measure the degree to which situations in one's life are appraised as stressful. The PSS showed adequate reliability and, as predicted, was correlated with life-event scores, depressive and physical symptomatology, utilization of health services, social anxiety, and smoking-reduction maintenance. In all comparisons, the PSS was a better predictor of the outcome in question than were life-event scores. When compared to a depressive symptomatology scale, the PSS was found to measure a different and independently predictive construct. Additional data indicate adequate reliability and validity of a four-item version of the PSS for telephone interviews. The PSS is suggested for examining the role of nonspecific appraised stress in the etiology of disease and behavioral disorders and as an outcome measure of experienced levels of stress.

Vitamin Supplementation for 1 Year Improves Mood

Article

Feb 1995

The possibility that the taking of vitamin supplements may influence mood was explored. One hundred and twenty-nine young healthy adults took either 10 times the recommended daily dose of 9 vitamins, or a placebo, under a double-blind procedure, for a year. Males taking the vitamins differed from those taking the placebo in that they reported themselves as feeling more 'agreeable' after 12 months. After 12 months the mood of females taking the vitamin supplement was significantly improved in that they felt more 'agreeable', more composed and reported better mental health. These changes in mood after a year occurred even though the blood status of 9 vitamins reached a plateau after 3 months: this improvement in mood was associated in particular with improved riboflavin and pyridoxine status. In females baseline thiamin status was associated with poor mood and an improvement in thiamin status after 3 months was associated with improved mood.

Vitamin E and vitamin C supplement use and risk of all-cause and coronary heart disease mortality in older persons: The Established Populations for Epidemiologic Studies of the Elderly

Article

Sep 1996

We examined vitamin E and vitamin C supplement use in relation to mortality risk and whether vitamin C enhanced the effects of vitamin E in 11,178 persons aged 67-105 y who participated in the Established Populations for Epidemiologic Studies of the Elderly in 1984-1993. Participants were asked to report all nonprescription drugs currently used, including vitamin supplements. Persons were defined as users of these supplements if they reported individual vitamin E and/or vitamin C use, not part of a multivitamin. During the follow-up period there were 3490 deaths. Use of vitamin E reduced the risk of all-cause mortality [relative risk (RR) = 0.66; 95% CI: 0.53, 0.83] and risk of coronary disease mortality (RR = 0.53; 95% CI: 0.34, 0.84). Use of vitamin E at two points in time was also associated with reduced risk of total mortality compared with that in persons who did not use any vitamin supplements. Effects were strongest for coronary heart disease mortality (RR = 0.37; 95% CI: 0.15, 0.90). The RR for cancer mortality was 0.41 (95% CI: 0.15, 1.08). Simultaneous use of vitamins E and C was associated with a lower risk of total mortality (RR = 0.58; 95% CI: 0.42, 0.79) and coronary mortality (RR = 0.47; 95% CI: 0.25, 0.87). Adjustment for alcohol use, smoking history, aspirin use, and medical conditions did not substantially alter these findings. These findings are consistent with those for younger persons and suggest protective effects of vitamin E supplements in the elderly.

Double-blind study of a multivitamin complex supplemented with Ginseng extract

Article

Feb 1996

To remedy the deterioration in quality of life in large cities, the addition of ginseng root extract to a multivitamin base appears to produce a promising dietary supplement. The aim of the present study was to compare the quality-of-life parameters in subjects receiving multivitamins plus ginseng with those found in subjects receiving multivitamins alone. The study was comparative, randomized and double-blind, and it involved 625 patients of both sexes divided into two groups taking one capsule per day for 12 weeks. Group A received vitamins, minerals, trace elements and ginseng extract G115 (Pharmaton Capsules) while group B received vitamins, minerals and trace elements (multivitamin capsules) only. The resulting quality-of-life was assessed by a standardized 11-item questionnaire, validated by the Medical School of the National Autonomous University of Mexico (UNAM). Of the 625 patients recruited, 124 were excluded from the study due to lack of compliance with the treatment, so that 338 patients in group A and 163 patients in group B completed the study. By the end of the study, the 4th of the monthly assessments showed that both the group-A and the group-B treatments had induced a significant increase in the quality-of-life index, the change being 11.9 points for Pharmaton Capsules in group A which was significantly superior to the 6.4 average increase with the group-B capsules containing multivitamins alone. Group A showed significant improvement in every one of the 11 questionnaire items, whereas group B did not show significant improvement in any of these items. Significant increases in body weight and in diastolic blood pressure were recorded in the group B treated with the multivitamin alone. Adverse effects of the capsules were minimal in both groups. This study has demonstrated that Pharmaton Capsules were more effective than the multivitamin capsules alone in improving the quality-of-life in a population subjected to the stress of high physical and mental activity.

Thiamine supplementation mood and cognitive functioning

Article

Feb 1997

One hundred and twenty young adult females took either a placebo or 50 mg thiamine, each day for 2 months. Before and after taking the tablets, mood, memory and reaction times were monitored. An improvement in thiamine status was associated with reports of being more clearheaded, composed and energetic. The taking of thiamine had no influence on memory but reaction times were faster following supplementation. These influences took place in subjects whose thiamine status, according to the traditional criterion, was adequate.

Periconceptual folic acid containing multivitamin supplementation

Article

Jul 1998
EUR J OBSTET GYN R B

Andrew E. Czeizel

Objective: A summary about the final results of the Hungarian double-blind placebo controlled randomised trial of periconceptional folic acid containing multivitamin and trace element supplementation. Results: The major finding is a significant prevention of the first occurrence of neural-tube defect, urinary tract and cardiovascular defects, in addition a decrease in the rate of limb deficiencies and congenital hypertrophic pyloric stenosis. Fertility was slightly improved and the rate of twins increased significantly after periconceptional multivitamin supplementation. The effect of multivitamin supplementation for fetal death is controversial, but in general there is no clinically significant change. Periconceptional multivitamin supplementation can reduce the occurrence of nausea and vomiting. Practical implementations: Consumption of foods which are rich in folate may not be the best way to prevent neural-tube defects and other congenital abnormalities. Periconceptional multivitamin supplementation is part of the periconceptional care in Hungary and it is an appropriate forum for the practical delivery for this primary prevention action. However, as a large proportion of pregnancies are unplanned, the widespread use of bread fortified with folic acid, vitamin B12 and B6 may decrease a considerable part of neural-tube defects and some other congenital abnormalities, in addition to vascular diseases due to hyperhomocysteinemia.

Vitamin E and Vitamin C Supplement Use and Risk of Incident Alzheimer Disease

Article

Oct 1998
ALZ DIS ASSOC DIS

Oxidative stress may play a role in neurologic disease. The present study examined the relation between use of vitamin E and vitamin C and incident Alzheimer disease in a prospective study of 633 persons 65 years and older. A stratified random sample was selected from a disease-free population. At baseline, all vitamin supplements taken in the previous 2 weeks were identified by direct inspection. After an average follow-up period of 4.3 years, 91 of the sample participants with vitamin information met accepted criteria for the clinical diagnosis of Alzheimer disease. None of the 27 vitamin E supplement users had Alzheimer disease compared with 3.9 predicted based on the crude observed incidence among nonusers (p = 0.04) and 2.5 predicted based on age, sex, years of education, and length of follow-up interval (p = 0.23). None of the 23 vitamin C supplement users had Alzheimer disease compared with 3.3 predicted based on the crude observed incidence among nonusers (p = 0.10) and 3.2 predicted adjusted for age, sex, education, and follow-up interval (p = 0.04). There was no relation between Alzheimer disease and use of multivitamins. These data suggest that use of the higher-dose vitamin E and vitamin C supplements may lower the risk of Alzheimer disease.

A double-blind placebo-controlled study of the effects of an oral multivitamin combination with calcium and magnesium on psychological well-being and cardiovascu-lar reactions to stress in healthy young male volunteers Vitamin use and beliefs among students at a Ma-laysian university

Jan 1990
175-184132

G Petchot
Bacque J-P B Alleaume
Ring M C Suter
Carroll

G, Petchot-Bacque J-P, Alleaume B, Suter M, Ring C, Carroll D (1997) A double-blind placebo-controlled study of the effects of an oral multivitamin combination with calcium and magnesium on psychological well-being and cardiovascu-lar reactions to stress in healthy young male volunteers. Eur J Clin Res 9:175–184 Yong MB (1990) Vitamin use and beliefs among students at a Ma-laysian university. J R Soc Health 110:132–134

A global measure of perceived stress Periconceptional folic acid containing multivi-tamin supplementation

Jan 1983
385-396151

S T Kamarck
Mermelstein

S, Kamarck T, Mermelstein R (1983) A global measure of perceived stress. J Health Soc Behav 24:385–396 Czeizel AE (1998) Periconceptional folic acid containing multivi-tamin supplementation. Eur J Obstet Gynecol Reprod Biol 78:151–161

A user's guide to the General Health Questionnaire. NFER-Nelson, Berkshire Hemila H (1996) Vitamin, and common cold symptoms: problems with inaccurate reviews

Jan 1988
804-809

D P Williams

D, Williams P (1988) A user's guide to the General Health Questionnaire. NFER-Nelson, Berkshire Hemila H (1996) Vitamin, and common cold symptoms: problems with inaccurate reviews. Nutrition 12:804–809

The effects of an oral multivitamin combination with calcium, magnesium, and zinc on psychological well-being in healthy young male volunteers: A double-blind placebo-controlled trial

Abstract

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