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Omega-3 Supplementation Lowers Inflammation and Anxiety in Medical Students: A Randomized Controlled Trial
Abstract
Observational studies have linked lower omega-3 (n-3) polyunsaturated fatty acids (PUFAs) and higher omega-6 (n-6) PUFAs with inflammation and depression, but randomized controlled trial (RCT) data have been mixed. To determine whether n-3 decreases proinflammatory cytokine production and depressive and anxiety symptoms in healthy young adults, this parallel group, placebo-controlled, double-blind 12-week RCT compared n-3 supplementation with placebo. The participants, 68 medical students, provided serial blood samples during lower-stress periods as well as on days before an exam. The students received either n-3 (2.5 g/d, 2085 mg eicosapentaenoic acid and 348 mg docosahexanoic acid) or placebo capsules that mirrored the proportions of fatty acids in the typical American diet. Compared to controls, those students who received n-3 showed a 14% decrease in lipopolysaccharide (LPS) stimulated interleukin 6 (IL-6) production and a 20% reduction in anxiety symptoms, without significant change in depressive symptoms. Individuals differ in absorption and metabolism of n-3 PUFA supplements, as well as in adherence; accordingly, planned secondary analyses that used the plasma n-6:n-3 ratio in place of treatment group showed that decreasing n-6:n-3 ratios led to lower anxiety and reductions in stimulated IL-6 and tumor necrosis factor alpha (TNF-α) production, as well as marginal differences in serum TNF-α. These data suggest that n-3 supplementation can reduce inflammation and anxiety even among healthy young adults. The reduction in anxiety symptoms associated with n-3 supplementation provides the first evidence that n-3 may have potential anxiolytic benefits for individuals without an anxiety disorder diagnosis. ClinicalTrials.gov identifier: NCT00519779.
... Plasma inflammatory biomarkers have also been inversely associated with DPA levels [72]. Conversely, n-3 PUFA supplementation was able to modulate cytokines involved in inflammation [73][74][75][76]. For instance, DHA and EPA supplementation significantly reduced the IL-6 and TNF-α levels in older adults with mild cognitive impairment [73]. ...
... In patients with type 2 diabetes, supplementation with VLC n-3 PUFAs was found to decrease the TNF-α and c-reactive protein levels [76]. Additionally, n-3 PUFA supplementation decreased LPS-stimulated IL-6 and TNF-α production in healthy young adults [74] and decreased circulating inflammatory markers in adults [75]. ...
... In addition, low plasma levels of n-3 PUFA have been found in patients with social anxiety disorders [112], and it has been associated with a higher likelihood of anxiety in women [113]. The hypothesis that n-3 PUFA deficiency is causal in anxiety is supported by studies showing that n-3 PUFA supplementation resulted in a reduction in anxiety symptoms in young adults without a diagnosis of anxiety disorder compared with the controls [74]. The results obtained in animal models also supported this idea. ...
Alcohol use poses a significant global health concern, leading to serious physical and socioeconomic issues worldwide. The current treatment options for problematic alcohol consumption are limited, leading to the exploration of alternative approaches, such as nutraceuticals. One promising target is very-long-chain n-3 polyunsaturated fatty acids (VLC n-3 PUFAs). This review aims to compile the most relevant pre-clinical and clinical evidence on the effect of VLC n-3 PUFAs on alcohol use disorders and related outcomes. The findings suggest that VLC n-3 PUFAs may alleviate the physiological changes induced by alcohol consumption, including neuroinflammation and neurotransmitter dysregulation. Additionally, they can reduce withdrawal symptoms, improve mood, and reduce stress level, all of which are closely associated with problematic alcohol consumption. However, more research is required to fully understand the precise mechanisms by which VLC n-3 PUFAs exert their function. Furthermore, PUFAs should not be considered a standalone solution, but as a complement to other therapeutic approaches. Although preliminary evidence supports the potential therapeutic effect of VLC n-3 PUFAs on problematic alcohol consumption, additional research is needed to validate these findings and determine the optimal use of PUFAs as part of a comprehensive approach to the treatment of alcohol use disorders.
... Of those, 158 duplicates were removed, 571 articles were excluded after title and abstract screening, 62 articles were assessed by full-text reading and 52 were excluded with reasons. Ten studies were included in the quantitative analysis with a mean duration of 11 weeks and a total of 1509 participants (68% female) of a mean age of 46.9 years [50][51][52][53][54][55][56][57][58][59]. The effects of DPAn-3 on measures of anxiety or depression were not assessed by any of the identified trials. ...
... The severity of anxious and/or depressive symptoms following EPA with/ without DHA supplementation were assessed by several validated scales comprising HDRS, BDI, BAI, CES-D, IDS, MADRS, HSCL and GDS. Participants were generally healthy (non-clinical) adults in three RCTs [51][52][53]. The remainder of the RCTs comprised adults with various degrees of severity of depression and/or anxiety [50,[54][55][56][57][58][59]. ...
... The remainder of the RCTs comprised adults with various degrees of severity of depression and/or anxiety [50,[54][55][56][57][58][59]. Five RCTs compared EPA-enriched, mixed preparations of EPA/DHA vs. placebo [51,52,54,55,59]. Of the remaining RCTs, one compared low vs. high dose of EPA vs. placebo [49], one compared equal doses of EPA vs. DHA vs. placebo [57], one compared high vs. low EPA-enriched, mixed preparations of EPA and DHA vs. placebo [53] and two compared EPA-enriched vs. DHA-enriched mixed preparations of EPA and DHA vs. placebo [56,58]. ...
The omega-3 polyunsaturated fatty acids (PUFAs) eicosapentaenoic- (EPA), docosahexaenoic- (DHA) and docosapentaenoic acid (DPAn-3) are promising therapeutic options in reducing the severity of anxious and depressive symptoms. However, meta-analyses of randomised controlled trials (RCTs) yield mixed findings. This systematic review and meta-analysis reviewed the evidence and assessed the efficacy of EPA, DHA and DPAn-3 in reducing the severity of anxiety and depression with specific consideration to methodological complications unique to the field e.g., dose and ratio of omega-3 PUFAs and placebo composition. Random-effects meta-analysis of ten RCTs comprising 1426 participants revealed statistically significant reduction in depression severity with EPA-enriched interventions at proportions ≥ 60% of total EPA + DHA (SMD: -0.36; 95% CI: -0.68, -0.05; p = 0.02) (I2 = 86%) and EPA doses between ≥ 1 g/day and < 2 g/day (SMD: -0.43; 95% CI: -0.79, -0.07; p = 0.02) (I2 = 88%); however, EPA doses ≥ 2 g/day were not associated with significant therapeutic effects (SMD: -0.20; 95% CI: -0.48, 0.07; p = 0.14). Only one study reported significant reduction in anxiety severity with 2.1 g/day EPA (85.6% of total EPA + DHA), therefore meta-analysis was not possible. No trials administering DPAn-3 were identified. Visual examination of the funnel plot revealed asymmetry, suggesting publication bias and heterogeneity amongst the trials. These results support the therapeutic potential of EPA in depression at proportions ≥ 60% of total EPA + DHA and doses ≥ 1 g/day and < 2 g/day. The observed publication bias and heterogeneity amongst the trials reflect the need for more high-quality trials in this area with consideration to the unique nature of omega-3 PUFAs research, to more fully elucidate the therapeutic potential of EPA, DHA and DPAn-3.
... Of those, 158 duplicates were removed, 571 articles were excluded after title and abstract screening, 62 articles were assessed by full-text reading and 52 were excluded with reasons. Ten studies were included in the quantitative analysis with a mean duration of 11 weeks and a total of 1509 participants (68% female) of a mean age of 46.9 years [48][49][50][51][52][53][54][55][56][57]. The effects of DPAn-3 on measures of anxiety or depression were not assessed by any identified trial. ...
... Two of the RCTs administered paraffin oil as a placebo [48,57]. Of note, two RCTs administered a mixed-fat placebo regime comprising palm, soy, canola, coco butter and olive oil, to approximate the saturated:monounsaturated:polyunsaturated fat ratio consumed by adults in the U.S.A. [50,51]. Due to the mixed-fat nature of this placebo the reviewers considered the dose of olive oil provided to be insufficient to confound the analysis and consequently the two trials were considered eligible for inclusion. ...
... One RCT assessed the effects of EPA and EPA-enriched, mixed EPA/DHA interventions on anxiety, reporting findings as least squares means adjusted for baseline value, visit, and gender [50]. Six RCTs assessed EPA and EPA-enriched, mixed EPA/DHA interventions on measures of depression and reported findings as mean scores at study entry and endpoint [48,49,52], unadjusted means at endpoint [53], is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint ...
First-line treatment for anxiety and depressive disorders comprises pharmacotherapy and psychotherapy; options not safe, effective, or suitable for all. Mounting evidence suggests that the omega-3 polyunsaturated fatty acids (PUFAs) eicosapentaenoic (EPA), docosahexaenoic (DHA) and docosapentaenoic (DPAn-3) acids are promising therapeutic options. However, meta-analyses of randomised controlled trials (RCTs) have produced inconsistent findings. This review assesses for the first time the efficacy of omega-3 PUFAs against the severity of anxiety and depression symptoms, measured by validated scales, with specific consideration of methodological issues encountered in this area. PubMed, CINAHL, PsycINFO, Cochrane Library and Web of Science were searched for eligible RCTs administering omega-3 PUFAs against anxiety and/or depression. This study adopts the PRISMA guidelines. Ten RCTs comprising 1509 participants were included in the quantitative synthesis. EPA-enriched interventions at ≥60% of total EPA+DHA were associated with significant reduction in depression severity, compared to placebo (SMD: -0.32; 95% CI: -0.59, -0.06; p=0.02); however, EPA doses of ≥2000 mg/day were not (SMD: -0.11; 95% CI: -0.43, 0.20; p=0.48). Only 10 RCTs fulfilled the eligibility criteria, and there were some concerns regarding bias and population heterogeneity, highlighting the lack of high-quality RCTs in this area. Overall, these results support previous observations where EPA at proportions ≥60% of total EPA+DHA, up to 2000 mg, reduces depression scores. However, more trials are needed which specifically consider the unique nature of this type of research to elucidate the therapeutic potential of EPA, DHA and DPAn-3.
... Total daily dosage ranged between 18 and 5500 mg, for a minimum of 8 to a maximum of 84 days. Fourteen studies included a healthy sample of participants (e.g., students), either under stress conditions [57][58][59][60][61]63,64,67,71] or normal daily circumstances [55,56,62,68,69]. The included clinical populations were also highly heterogenous; that is, individuals were affected by anorexia nervosa [66], autism spectrum disorder (ASD) [65], or learning disabilities [70] with no anxiety diagnosis. ...
... A complete summary of study [55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71] characteristics is depicted in Table 1. Among the 11 studies that employed probiotics, a variety of species and strains were used: Saccharomyces boulardii, Lactobacillus casei Shirota, Lactobacillus plantarum DR7 or PS128, and Lactobacillus rhamnosus were administered singularly; or a combination of Lactobacilli, Bifidobacteria and/or Streptococcus. ...
... The included clinical populations were also highly heterogenous; that is, individuals were affected by anorexia nervosa [66], autism spectrum disorder (ASD) [65], or learning disabilities [70] with no anxiety diagnosis. Finally, a range of assessment tools were used to measure both anxiety (State-Trait Anxiety Inventory, Beck Anxiety Inventory, Child Behavior Checklist) Among the 17 included records, only 1 showed a low risk of bias [64], whereas 6 studies showed a high risk of bias [60,62,63,66,69,71] (see Figure S1). Reasons for moderate concerns in study designs were mostly related to the absence of pre-specified protocols to compare with the published reports and the absence of detailed and clear information about the randomization process. ...
This systematic review brings together human psychobiotic interventions in children and adolescents (aged 6–25 years) to evaluate the efficacy of pre- and probiotic supplements on stress, anxiety, and cognitive outcomes. Psychobiotic interventions in animal studies highlighted sensitivity to effects during development and maturation in multiple domains from emotion to cognitive processing. Several translational psychobiotic interventions in humans have been carried out to assess effects on emotion and cognition during childhood and into adulthood. The findings illustrate that there are limited consistent psychobiotic effects in developing human populations, and this is proposed to be due to heterogeneity in the trials conducted. Consequentially, it is recommended that three specific factors are considered in future psychobiotic trials: (1) Specificity of population studied (e.g., patients, developmental age), (2) specificity of intervention, and (3) homogeneity in outcome measures.
... 48 Randomized controlled trials indicate other markers of inflammation, lipopolysaccharides (LPS) and Interleukin-6 (IL-6), also drop with eicosapentaenoic acid (EPA) and docosahexaenoic (DHA) supplementation, with corresponding reductions in anxiety for subjects. 49 Meta-analyses confirm that there is efficacy in the utilization of EPA and DHA in treating depression and anxiety. 50, 51 Including omega-3 fatty acids regularly in the diet can play an important role in managing the depressive symptoms of PMDD. ...
... 52 Researchers found that the benefits of EPA/DHA supplementation came with a decrease in the omega-6:omega-3 ratio. 49 ...
Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) are mood disorders experienced by women of child-bearing age who are regularly experiencing their men-strual cycles. Symptoms experienced negatively impact women cognitively, socially, emotionally, and physically. A literature review was performed relevant to the behavioral effects of PMS and PMDD and symptomology. Nutritional and lifestyle interventions with evidence were analyzed and reviewed. Studies indicated that intestinal dysbiosis, the Western diet, inadequacies in omega-3 fatty acids, vitamin D, vitamin B6, iron, sun exposure, smoking, alcohol, and physical activity are linked to symptomology associated with PMS and PMDD. Addressing micronutrient and essential fatty acid deficiencies, intestinal dysbiosis, smoking avoidance, limiting alcohol consumption, promoting physical activity and sunlight exposure, and providing education on PMS and PMDD may improve symptoms associated with these conditions.
... The role of fatty acids in DM-induced anxiety is less clear; however, much evidence suggests that fatty acids may modulate mood [10][11][12][13]. It is known that an increased level of fatty acids in DM is associated with metainflammation and neuroinflammation, contributing to anxiety-like behaviour [10]. ...
... It is known that an increased level of fatty acids in DM is associated with metainflammation and neuroinflammation, contributing to anxiety-like behaviour [10]. Recent clinical trials confirmed that exogenous supplementation with n-3 and n-6 polyunsaturated fatty acids (PUFA) reduced serum inflammatory markers and anxiety in medical students [11], middle-age women [12] and in menopause [13]. Fatty acid level in the brain is closely interrelated to oxidative stress, since free fatty acids (FFAs) may be converted into toxic metabolites like ceramide and diacylglycerol, which stimulate ROS production [6]. ...
The aim of our study was to investigate the effects of a shortened daily photoperiod on anxiety-like behaviour, brain oxidative stress, lipid status and fatty acid composition of serum lipids in a streptozotocin (STZ)-induced model of diabetes mellitus in rats. Male Wistar rats were divided into the following groups: first group—control group (C12/12); second group—diabetic group (DM12/12; 100 mg/kg STZ); third group—control group exposed to a light/dark cycle 6/18 h (C6/18); fourth group—diabetic group exposed to a light/dark cycle 6/18 h (DM6/18). Anxiety-like behaviour was tested three weeks following STZ injection by elevated plus maze (EPM) and open-field test (OFT). Oxidative stress parameters were measured in the cortex, hippocampus and thalamus, while lipid status and fatty acid methyl esters (FAMEs) were measured in the serum. Both EPM and OFT showed a lower degree of anxiety-like behaviour in the DM6/18 vs. DM12/12 group. Lipid peroxidation in the cortex, hippocampus and thalamus was significantly lower in the DM6/18 vs. DM12/12 group (p < 0.05), associated with an increased level of antioxidant enzymes and protein thiols in the cortex and thalamus. In the DM6/18 group, oleic, vaccenic, dihomo-γ-linolenic and docosahexaenoic acid concentrations were significantly higher in comparison to the DM12/12 group. A shortened daily photoperiod alleviates anxiety-like behaviour in diabetic rats by reduced lipid peroxidation and changes in the serum fatty acids profile.
... Interestingly, studies indicate that people who eat omega-3 s regularly are less likely to be depressed [77,78]. What's more, when people with depression or anxiety start consuming omega-3 supplements, their symptoms improve [79,80]. ALA, EPA, and DHA are the three types of omega-3 fatty acids. ...
... It is a major public health issue because it increases your risk of many other illnesses, including heart disease and diabetes [88]. Omega-3 fatty acids can help insulin resistance, inflammation, and heart disease risk factors in people with metabolic syndrome [80,89,90]. ...
With the increasing interest in health and nutrition for longevity of life and more performance ability, the idea of health foods and nutrients has attracted more research and studies. Omega-3 fatty acid docosahexaenoic acid (DHA) is a nutrient molecule with various diverse roles and health benefits in the human body. Though DHA originally comes from microalgae and sea plants, the main source of DHA is fish, shellfish, and fish oils. DHA is a key nutrient with a structural and functional role in the cell membrane and cell organelles, and abundant in brain and eye. It is good for the heart, and protective against heart diseases. It is rather a very ancient molecule with more modern concepts. Really, DHA has been proven to be a key nutrient that is required in the processes of physical and mental development and health, and prevention of diseases throughout the life span. Driven by the values of physical and mental health, the demand for DHA in the international market is expected to grow. This review is an attempt to update the research findings about DHA and its health benefits in an easy and lucid way.
... Compared to control group, the intervention group had a 14% decrease in inflammation and a 20% reduction in anxiety scores, but not in depressive symptoms. Decreasing ratios of the plasma omega-6:omega-3 ratio led to lower anxiety scores and lower inflammation [87]. ...
... Diet quality is independently and inversely correlated with GHQ-12 [8], while intake of magnesium, folate, and zinc have been associated with mental health [12]. On the other hand, omega-3 fatty acid supplementation may not be an effective preventing measure against depression and anxiety symptoms [98], despite the positive findings in university students [87]. ...
Introduction: Mental health problems, especially depression and anxiety, among university students are widespread, and begin pre-matriculation. Diet is among the factors contributing to mental health in all age groups. Aim: The present review aims to critically summarize the observational studies and clinical trials that have investigated the association between mental health and diet quality in university student populations. Methods: PubMed was comprehensively searched to identify studies that explore the role of aspects of diet quality on quality of life, depression, and anxiety in university students. Results: Healthy dietary patterns, such as the Mediterranean and the DASH diet, diets with high intakes of antioxidants and antioxidant vitamins, folate, Zinc and Calcium are associated with less depressive symptoms. Higher alcohol and salt intake have also been associated with depression. Conclusion: Healthy dietary patterns, with adequate micronutrient and antioxidant intakes are associated with better mental health status. However, further randomised controlled clinical studies are needed in order to clarify the cause and the effect of the observed associations.
... Plasma samples of baseline and follow-up time points were processed according to the manufacturer's instructions (PreOmics iST kit, no.iST 96x). Briefly, 4 µL of individual samples were solubilized in 50 μL of "Lyse" buffer (containing Tris-HCl, sodium deoxycholate (SDC), 0.1% sodium dodecyl sulfate (SDS), tris (Yung et al., 2005;Wu et al., 2005;Hutchinson et al., 1999;Horan et al., 2006;Ventura et al., 2011;Robinson et al., 2004;Tohen et al., 2000;Bora and Pantelis, 2013;Carrión et al., 2013;Fusar-Poli et al., 2012;Giuliano et al., 2012;Lin et al., 2011;Meyer et al., 2014;Salokangas et al., 2013;Salokangas et al., 2014;Burton et al., 2019;Cannon et al., 2008;Buchy et al., 2014;Fusar-Poli et al., 2010;Dragt et al., 2011;Tarbox et al., 2013;Ziermans et al., 2014;Riecher-Rössler et al., 2009;Pukrop et al., 2007;Koutsouleris et al., 2012;Hoffman et al., 2007;Nieman et al., 2014;Lencz et al., 2006;Cornblatt et al., 2015;Corcoran et al., 2015;Thompson et al., 2011;Zimmermann et al., 2010;Albert et al., 2017;Miglietta et al., 2020;Tsuang et al., 2013;Riecher-Rössler and Studerus, 2017;Koutsouleris et al., 2018;Koutsouleris et al., 2015;van Tricht et al., 2014;Ramyead et al., 2016;Van Tricht et al., 2010;Muller et al., 2015;Müller, 2018;Hsu et al., 2020;Marrone and Coccurello, 2019;Healy-Stoffel and Levant, 2018;English et al., 2018;Focking et al., 2016;Focking et al., 2019;Heurich et al., 2021;Cannon et al., 2014;Berger et al., 2017;Smesny et al., 2014;Amminger et al., 2010;Susai et al., 2021;Perkins et al., 2015;Chan et al., 2015;Mongan, in press;Niendam et al., 2007;Bryson and Bell, 2003;Bowie et al., 2008;McFarlane et al., 2015;McFarlane et al., 2015;Allen et al., 2015;Markulev et al., 2017;Sekar et al., 2017;Sekar et al., 2016;McGorry et al., 2015;Overall and Gorham, 1962;Andreasen, 1989;Young et al., 1978;Montgomery and Asberg, 1979;Goldman et al., 1992;Auther and Global, 2006;Niendam et al., 2006;Alqarni et al., 2018;McLaverty et al., 2020;Kim et al., 2016;Bache et al., 2018;Beck et al., 2015;Meier et al., 2018;Cox and Mann, 2008;Malipatil et al., 2019;Morrison et al., 2012;Dwyer and Koutsouleris, 2022;n/a(n/ a).; Dwyer et al., 2018;Shatte et al., 2019;Koutsouleris et al., 2016;Ohara, 2007;Das, 2006;Kiecolt-Glaser et al., 2011;Kiecolt-Glaser et al., 2012;Pawelczyk et al., 2015;Cadenhead et al., 2018;Amminger et al., 2013;Berger et al., 2018;Cornblatt et al., 2012;Pouget et al., 2014;Pouget, 2018; phosphine (TCEP), and 2-chloroacetamide and heated to 95 • C for 10 min. 50 μL of the resulting denatured, reduced, and alkylated solution was transferred to the reaction tube. ...
... The membrane phospholipid hypothesis has specified the potential involvement of fatty acid imbalance in the development of psychosis (Muller et al., 2015;Müller, 2018;Focking et al., 2019;Heurich et al., 2021;Cannon et al., 2014;Das, 2006;Kiecolt-Glaser et al., 2011;Kiecolt-Glaser et al., 2012;Pawelczyk et al., 2015). However, very few clinical studies have investigated the biological relationship of omega-3 FAs with functional outcomes such as social, role functioning and occupational functioning in CHR participants Cadenhead et al., 2018;Amminger et al., 2013;Berger et al., 2018;Cornblatt et al., 2012). ...
Background
Functional outcomes are important measures in the overall clinical course of psychosis and individuals at clinical high-risk (CHR), however, prediction of functional outcome remains difficult based on clinical information alone. In the first part of this study, we evaluated whether a combination of biological and clinical variables could predict future functional outcome in CHR individuals. The complement and coagulation pathways have previously been identified as being of relevance to the pathophysiology of psychosis and have been found to contribute to the prediction of clinical outcome in CHR participants. Hence, in the second part we extended the analysis to evaluate specifically the relationship of complement and coagulation proteins with psychotic symptoms and functional outcome in CHR.
Materials and methods
We carried out plasma proteomics and measured plasma cytokine levels, and erythrocyte membrane fatty acid levels in a sub-sample (n=158) from the NEURAPRO clinical trial at baseline and 6 months follow up. Functional outcome was measured using Social and Occupational Functional assessment Score (SOFAS) scale. Firstly, we used support vector machine learning techniques to develop predictive models for functional outcome at 12 months. Secondly, we developed linear regression models to understand the association between 6-month follow-up levels of complement and coagulation proteins with 6-month follow-up measures of positive symptoms summary (PSS) scores and functional outcome.
Results and conclusion: A prediction model based on clinical and biological data including the plasma proteome, erythrocyte fatty acids and cytokines, poorly predicted functional outcome at 12 months follow-up in CHR participants. In linear regression models, four complement and coagulation proteins (coagulation protein X, Complement C1r subcomponent like protein, Complement C4A & Complement C5) indicated a significant association with functional outcome; and two proteins (coagulation factor IX and complement C5) positively associated with the PSS score. Our study does not provide support for the utility of cytokines, proteomic or fatty acid data for prediction of functional outcomes in individuals at high-risk for psychosis. However, the association of complement protein levels with clinical outcome suggests a role for the complement system and the activity of its related pathway in the functional impairment and positive symptom severity of CHR patients.
... Ejemplos de factores ambientales involucrados en esta problemática son la abundancia de alimentos, bajo estatus socioeconómico y la cultura. Por otro lado, entre los factores comportamentales se encuentra una ingesta excesiva de calorías, patrones de alimentación inadecuados, estilos de vida sedentarios y la falta de sueño (Kadouh & Acosta, 2017;Kiecolt-Glaser et al., 2011). ...
... which suppresses NFκB binding to DNA and thus inhibits transcription of additional inflammatory factors, including cytokines and toll-like receptors (Weldon et al., 2007;Oh et al., 2010;Block et al., 2012). Even in generally healthy individuals, daily EPA and DHA supplementation reduced circulating IL-6 and TNFα concentrations by about 15% (Kiecolt-Glaser et al., 2011;Kiecolt-Glaser et al., 2012). In mice genetically engineered to overproduce EPA and DHA, endotoxin-stimulated blood TNFα concentrations were 5-fold less than in normal mice, and hepatic gene expression was reduced for several inflammatory cytokines (Schmocker et al., 2007). ...
Intrauterine growth restriction (IUGR) arises when maternal stressors coincide with peak placental development, leading to placental insufficiency. When the expanding nutrient demands of the growing fetus subsequently exceed the capacity of the stunted placenta, fetal hypoxemia and hypoglycemia result. Poor fetal nutrient status stimulates greater release of inflammatory cytokines and catecholamines, which in turn lead to thrifty growth and metabolic programming that benefits fetal survival but is maladaptive after birth. Specifically, some IUGR fetal tissues develop enriched expression of inflammatory cytokine receptors and other signaling cascade components, which increases inflammatory sensitivity even when circulating inflammatory cytokines are no longer elevated after birth. Recent evidence indicates that greater inflammatory tone contributes to deficits in skeletal muscle growth and metabolism that are characteristic of IUGR offspring. These deficits underlie the metabolic dysfunction that markedly increases risk for metabolic diseases in IUGR-born individuals. The same programming mechanisms yield reduced metabolic efficiency, poor body composition, and inferior carcass quality in IUGR-born livestock. The ω-3 polyunsaturated fatty acids (PUFA) are diet-derived nutraceuticals with anti-inflammatory effects that have been used to improve conditions of chronic systemic inflammation, including intrauterine stress. In this review, we highlight the role of sustained systemic inflammation in the development of IUGR pathologies. We then discuss the potential for ω-3 PUFA supplementation to improve inflammation-mediated growth and metabolic deficits in IUGR offspring, along with potential barriers that must be considered when developing a supplementation strategy.
... One important type of such acids is DHA, which is abundant in the brain and alters functions of neural systems that utilize dopamine and serotonin, which play a role in depression (32). Another explanation is that omega-3 fatty acids have anti-inflammatory properties and can reduce the production of pro-inflammatory cytokines that contribute to depressive symptoms (33). In addition, emerging research suggest that omega-3 fatty acids benefit the gut microbiome (34), which is also critical for mental health. ...
Background
Postpartum depression (PPD) is the most common complication associated with childbirth and can lead to adverse outcomes for both mothers and their children. A previous meta-analysis found that PPD prevalence varies widely across countries. One potential underexplored contributor to this cross-national variation in PPD is diet, which contributes to mental health and varies significantly around the world. Here, we sought to update the global and national estimates of PPD prevalence using systematic review and meta-analysis. Further, we examined whether cross-national variation in PPD prevalence is associated with cross-national variation in diet using meta-regression.
Methods
To estimate national rates of PPD prevalence, we conducted an updated systematic review of all papers reporting PPD prevalence using the Edinburgh Postnatal Depression Scale between 2016–2021 and combined our findings with a previous meta-analysis of articles published between 1985–2015. PPD prevalence and methods were extracted from each study. Random effects meta-analysis was used to estimate global and national PPD prevalence. To examine dietary predictors, we extracted data on sugar-sweetened beverage, fruit, vegetable, total fiber, yogurt, and seafood consumption from the Global Dietary Database. Random effects meta-regression was used to test whether between-country and within-country variation in dietary factors predicted variation in PPD prevalence, controlling for economic and methodological variables.
Results
412 studies of 792,055 women from 46 countries were identified. The global pooled prevalence of PPD was 19.18% (95% confidence interval: 18.02 to 20.34%), ranging from 3% in Singapore to 44% in South Africa. Countries that consumed more sugar-sweetened beverages (SSBs) had higher rates of PPD (Coef. = 0.325, p = 0.044, CI:0.010–0.680); Moreover, in years when higher rates of sugar-sweetened beverages were consumed in a country, there were correspondingly higher rates of PPD in that country (Coef. = 0.129, p = 0.026, CI: 0.016–0.242).
Conclusion
The global prevalence of PPD is greater than previous calculations, and drastically varies by country. Sugar-sweetened beverage consumption explained some of the national variation in PPD prevalence.
... In an RCT conducted with student participants, Kiecolt-Glaser et al. (2011) showed that a supplement of n-3 LCPUFA at 2.5 g/day (2.1 g EPA and 0.35 g DHA) for 12 weeks decreased IL-6 and TNF-α production (∼14%) by PBMC following LPS stimulation compared to the placebo group. Akin to Ferguson et al. (2014a), this study observed no difference in plasma levels of inflammatory IL-6 and TNF-α production without stimulation. ...
The immune system requires an adequate supply of nutrients, although current dietary recommendations may not account for optimal immune function in healthy adults. Nutrient inadequacies due to the growing influence of the western diet pose a risk for immune dysfunction. This review aims to determine the beneficial effects of supplementing: dietary fats, nutrients that modulate gut microbiota, and specific micronutrients, on systemic immune functions (concentrations of plasma cytokines, antibodies and acute phase proteins) during health and acute inflammatory conditions, including COVID-19. We discussed micronutrients (selenium, zinc and vitamin D) with compelling evidence supporting immunomodulatory properties. Additionally, the synergistic effects of physical activity and dietary interventions on systemic immune markers are explored. Briefly, evidence suggests that dietary consumption of monounsaturated (oleic and palmitoleic acids) and omega-3 polyunsaturated fatty acids (eicosapentaenoic and docosahexaenoic acids) promotes anti-inflammatory properties. Food sources (fiber, prebiotics, probiotics, omega-3) and patterns (Mediterranean diet) increase the production of short-chain fatty acids, beneficially altering gut microbiota composition, which subsequently enhances the immunomodulatory properties of circulating immune cells. A positive synergistic role of nutrient supplementation (omega-3 and fiber) and physical activity on circulating C-reactive protein and interleukin-6 levels have been observed. Lastly, omega-3 supplementation during COVID-19 infection may reduce circulating C-reactive protein and pro-inflammatory cytokines and improves pain and fatigue symptoms. This review highlights recent findings that support the beneficial role of specific nutrients in promoting systemic immune function in healthy adults. However, to establish specific dietary recommendations to support optimal immune function, more research is required.
... The second was fatty acids linked to depression and brain inflammation. Several studies have shown that fatty acids are significantly associated with depression and brain inflammation [84][85][86][87][88]. Diet is known to influence oxidative stress, inflammation, and brain plasticity and function; all of these physiological aspects may play a role in the development of depression [89]. ...
Background
Numerous epidemiological studies have examined the relationship between dietary intake of specific foods or nutrients and the incidence of depression and have noted that nutrition has a significant impact on mental health. Therefore, the purpose of this study is to assess the state of research, the frontiers of research, and development trends in the field of nutrition and depression using bibliometric and visual analysis.
Methods
We collected publications on the topic of nutrition and depression from Scopus between 2002 and 2021. Subsequently, we utilized VOSviewer 1.6.18 and Microsoft Excel 2013 to perform bibliometric analysis and visualization. Bibliometric analysis involves retrieving documents from a singular database, such as SciVerse Scopus or Web of Knowledge, and subjecting them to quantitative and qualitative analysis. Notably, gray literature is not considered in bibliometric analysis.
Results
A total of 2171 publications on nutrition and depression were found between 2002 and 2021, namely 1855 (85.44%) original articles, 190 (8.75%) reviews, 38 (1.75%) letters, and 88 (4.05%) other types of publications. The most productive country was found to be the USA (n = 726; 33.44%), followed by Australia (n = 172; 7.92%), the United Kingdom (n = 158; 7.28%), China (n = 132; 6.08%), and Canada (n = 131; 6.03%). The remaining publications were from other countries (n = 852; 39.25%). According to the citation analysis, the retrieved papers were cited on an average of 26.6 times and had an h-index of 105 with 57,781 citations. The most frequent terms on the map include those related to (a) fatty acid links to depression and brain inflammation, (b) depression and eating disorders, and finally, (c) adherence to the Mediterranean diet and risk of depression.
Conclusions
The current study was the first novel bibliometric analysis of nutrition and depression research that used data extracted from Scopus for visualization network mapping. In recent years, the theme "Mediterranean diet adherence and risk of depression" has been identified more frequently, indicating that studies in this field have garnered considerable attention and reflect the most recent scientific advances. Researchers should continue to investigate nutrition and depression, and we believe this study provides significant information for researchers, nutritionists, and clinicians.
... Die Evidenz zur Wirksamkeit anderer Supplemente ist wesentlich dürftiger und bezieht sich meist auf PUFA (mehrfach ungesättigte Fettsäuren, polyunsaturated fatty acids). Eine Supplementierung mit Docosahexansäure (DHA) über 8 Wochen konnte eine 50 %ige Reduktion der Depressionssymptomatik erwirken (Smith et al. 2018b) und in einer placebokontrollierten Studie mit 68 MedizinstudentInnen über 12 Wochen Angst signifikant reduzieren, aber keine Veränderungen der depressiven Symptome erzeugen (Kiecolt-Glaser et al. 2011). Es konnte eine Abnahme von Entzündungsstoffen wie Interleukin-6 und TNF-α, beobachtet werden. ...
Die Integration komplementärmedizinischer Behandlungsverfahren in konventionelle pharmako- und psychotherapeutische Konzepte spielt auch in der Psychiatrie eine zunehmende Rolle. Einerseits ist die Inanspruchnahme von Komplementärmedizin – mit oder ohne Wissen der hauptsächlichen Behandler – bei PatientInnen weit verbreitet, andererseits gibt es vielfältige wissenschaftliche Belege für die Wirksamkeit einzelner komplementärmedizinischer Therapien insbesondere auch bei Depression. Hierzu zählen die klassische Naturheilkunde mit ihren Komponenten Phytotherapie, Hydrotherapie, Ernährung, Bewegungs- und Physiotherapie und Ordnungstherapie bzw. Mind-Body-Medizin. Die traditionelle indische Medizin mit Ayurveda und Yoga sowie die Chinesische Medizin mit Akupunktur und den meditativen Übungstechniken werden dargestellt. Schließlich finden anthroposophische Medizin und Homöopathie in diesem Kapitel Beachtung.
... Similarly, Kiecolt-Glaser and colleagus reported non-serious adverse events with omega 3 fatty acids administration including, sore throat, nasal symptoms, stomach pain, tachycardia, and Diarrhea with non significant differences between intervention and control group (20) . ...
... Supplementation with omega-3 fatty acids may help relieve some of the anxious sensations experienced by young, healthy individuals who have not been diagnosed with an anxiety condition. This finding lends support to the concept that the use of fish oil DSs is a helpful practice [28]. Even though DS has had a generally positive reputation about its safety, there is always the potential for unfavorable outcomes if it is used without a physician's supervision [29]. ...
... People with anxiety and depression have been found to have decreased ω3 PUFA levels in the blood and brain, as well as a lower ratio of ω3 to ω6 PUFAs [70][71][72]. A placebo-controlled study demonstrated that supplementation of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) over 12 weeks reduced the severity of symptoms of anxiety by 20% among medical students [73]. Additionally, a meta-analysis of 402 patients with major depressive disorder identi ied adjuvant ω3 PUFA as bene icial for managing anxiety and depression [74]. ...
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.
... There is evidence showing that GABRA1 can improve anxiety behavior in rats (Gupta et al., 2019). In parallel, the inflammation is also closely related to the pathophysiology of depression and anxiety (Kiecolt-Glaser et al., 2011). TNF-α and IL-1β are pro-inflammatory cytokines that affect neuronal function by regulating oxidative stress, apoptosis, and metabolism, and impairing neuronal branching processes There is evidence demonstrating that TNF-α plays a critical role in the cognitive decline and the progression of depression and anxiety, while both IL-1β and TNF-α are elevated in patients with depression. ...
Anxiety disorder is one of the most common mental diseases. It is mainly characterized by a sudden, recurring but indescribable panic, fear, tension and/or anxiety. Yangshendingzhi granules (YSDZ) are widely used in the treatment of anxiety disorders, but its active ingredients and underlying mechanisms are not yet clear. This study integrates network pharmacology and metabolomics to investigate the potential mechanism of action of YSDZ in a rat model of anxiety. First, potential active ingredients and targets were screened by network pharmacology. Then, predictions were verified by molecular docking, molecular dynamics and western blotting. Metabolomics was used to identify differential metabolites and metabolic pathways. All results were integrated for a comprehensive analysis. Network pharmacology analysis found that Carotene, β-sitosterol, quercetin, Stigmasterol, and kaempferol in YSDZ exert anxiolytic effects mainly by acting on IL1β, GABRA1, PTGS1, ESR1, and TNF targets. Molecular docking results showed that all the affinities were lower than −5 kcal/mol, and the average affinities were −7.7764 kcal/mol. Molecular dynamics simulation results showed that RMSD was lower than 2.5 A, and the overall conformational changes of proteins were small, indicating that the small molecules formed stable complexes with proteins. The results of animal experiments showed that YSDZ exerts anxiolytic effects by regulating GABRA1 and TNF-α, ameliorating pathological damage in hippocampal CA1, and regulating metabolic pathways such as thiamine, cysteine and methionine metabolism, lysine biosynthesis and degradation. Altogether, we reveal multiple mechanisms through which YSDZ exerts its anti-anxiety effects, which may provide a reference for its clinical application and drug development.
... Some studies explored the potential depression preventive effects of omega-3 fatty acids. With respect to this role, omega-3 fatty acids are less efficacious in healthy subjects [117,118], women at risk for peripartum depression [119,120], or patients with high cardiovascular risk [121,122]. Interestingly, Su et al. proved that n-3 PUFAs had a therapeutic benefit in pregnant women suffering from MDD and displayed no adverse effects on patients or newborns. ...
Since depression remains a major public health issue there is a constant need for new and more efficient therapeutic strategies based on the mechanisms involved in the aetiology of depression. Thus, the pathogenic link between depression and inflammation is considered to play a potential key role in the development of such therapies. This review summarizes the results of various pharmacological (non-steroidal anti-inflammatory drugs, aspirin, cyclooxygenase inhibitors, cytokine inhibitors, corticosteroids, statins, minocycline, N-acetyl cysteine, omega-3 fatty acids and probiotics) and non-pharmacological interventions (electroconvulsive therapy, physical exercise and psychological therapy) and outlines their efficacy and discusses potential challenges. Both conventional and non-conventional anti-inflammatory drugs showed promising results according to the specific group of patients. The pre-existing pro-inflammatory status was, in most cases, a predictor for clinical efficacy and, in some cases, a correlation between clinical improvement and changes in various biomarkers was found. Some of the non-pharmacological interventions (physical exercise and electroconvulsive therapy) have also showed beneficial effects for depressive patients with elevated inflammatory markers. Treatments with anti-inflammatory action may improve clinical outcomes in depression, at least for some categories of patients, thus opening the way for a future personalised approach to patients with unipolar depression regarding the inflammation-related mechanism.
... The underlying mechanisms of neuropsychiatric disorders in AD are still unclear, but associations are potentially driven by the harmful effects of AD on quality of life (Chrostowska-Plak et al., 2013;Senra and Wollenberg, 2014), unbearable chronic itch, and sleeplessness (Weisshaar et al., 2008). Clinical investigations have associated depression, anxiety, and autism with elevated levels of proinflammatory (although not Th2) cytokines (Kiecolt-Glaser et al., 2011;Pollak and Yirmiya, 2002;Zimmerman et al., 2005), which theoretically could penetrate the bloodbrain barrier (Yarlagadda et al., 2009) and modulate behavior and emotions (Buske-Kirschbaum et al., 2013;Ishiuji et al., 2009;Raison et al., 2006;Rosenkranz et al., 2005). Other chronic health conditions of childhood also increase the risk of emotional and behavioral problems, including attention deficit/hyperactivity disorder (Blackman et al., 2011). ...
p>Atopic dermatitis comorbidities extend well beyond the march to allergic conditions (food allergy, asthma, allergic rhinitis, allergic conjunctivitis, and eosinophilic esophagitis), suggesting both cutaneous and systemic immune activation. In reviewing atopic dermatitis comorbidities, Councilors of the International Eczema Council found a strong pattern of immune activation in peripheral blood and the propensity to both skin and systemic infections. Associations with cardiovascular, neuropsychiatric, and malignant diseases were increasingly reported, but confirmation of their link with atopic dermatitis requires longitudinal studies. Given the possibility of atopic dermatitis-related systemic immune activation, future investigations of new interventions should concurrently examine the impact on these comorbidities.</p
... Medical students given 2.5 g/d, 2085 mg EPA and 348 mg DHA (OmegaBrite TM , Waltham, MA, USA) or placebo capsules resulted in plasma levels 6-fold higher of EPA and 50% higher DHA compared to levels prior to supplementation [186]. ...
This paper presents remarkably uniform data showing that higher NLR is a robust prognostic indicator of shorter overall survival across the common metastatic cancers. Myeloid derived suppressor cells, the NLRP3 inflammasome, neutrophil extracellular traps, and absolute neutrophil count tend to all be directly related to the NLR. They, individually and as an ensemble, contribute to cancer growth and metastasis. The multidrug regimen presented in this paper, TICO, was designed to decrease the NLR with potential to also reduce the other neutrophil related elements favoring malignant growth. TICO is comprised of already marketed generic drugs: the phosphodiesterase 5 inhibitor tadalafil, used to treat inadequate erections; isotretinoin, the retinoid used for acne treatment; colchicine, a standard gout (podagra) treatment; and the common fish oil supplement omega-3 polyunsaturated fatty acids. These individually impose low side effect burdens. The drugs of TICO are old, cheap, well known, and available worldwide. They all have evidence of lowering the NLR or the growth contributing elements related to the NLR when clinically used in general medicine as reviewed in this paper.
... For instance, fish oil supplementation (38.2 g/day EPA + DHA during 90 days) lowered the blood levels of pro-inflammatory markers in hypertensive patients [38]. Similarly, healthy young adults receiving n-3 PUFA (2.5 g/day, 2085 mg EPA and 348 mg DHA) for 12 weeks underwent a 14% decrease in serum IL-6 levels [39]. Likewise, low (1.25 g/day) or high (2.5 g/day) doses of n-3 PUFA supplementation for 4 months reduced inflammation responses (specifically serum IL-6 and TNF-α concentrations) in overweight adults [40]. ...
Purpose of Review
Chronic low-grade inflammation may contribute to the onset and progression of communicable and chronic diseases. This review examined the effects and eventual mediation roles of different nutritional factors on inflammation.
Recent Findings
Potential nutritional compounds influencing inflammation processes include macro and micronutrients, bioactive molecules (polyphenols), specific food components, and culinary ingredients as well as standardized dietary patterns, eating habits, and chrononutrition features. Therefore, research in this field is still required, taking into account critical aspects of heterogeneity including type of population, minimum and maximum intakes and adverse effects, cooking methods, physiopathological status, and times of intervention. Moreover, the integrative analysis of traditional variables (age, sex, metabolic profile, clinical history, body phenotype, habitual dietary intake, physical activity levels, and lifestyle) together with individualized issues (genetic background, epigenetic signatures, microbiota composition, gene expression profiles, and metabolomic fingerprints) may contribute to the knowledge and prescription of more personalized treatments aimed to improving the precision medical management of inflammation as well as the design of anti-inflammatory diets in chronic and communicable diseases.
... In line with other studies [17,21,43], we found that fish oil, a rich source of long-chain omega-3 fatty acids, is among university students' most frequently used non-vitamin-mineral supplements. In addition to a general perception that consumption of fish oil DSs is a healthy eating habit [44], there is evidence that omega-3 fatty acids supplementation may have potential anxiolytic benefits for healthy young adults without anxiety disorder diagnosis [45]. ...
The rising popularity of dietary supplements as a part of self-care practice increases interest in monitoring their usage in the general and specific population groups. This study investigated the prevalence and patterns of dietary supplement use among Belgrade University undergraduate students and its variations across different academic study fields. Of the 914 online survey students, 55.7% used dietary supplements during the past year. Female gender, eating behavior, and academic field were significant predictors of dietary supplement use. For all students, the most commonly used dietary supplements were vitamins and minerals, alone or in combination. Magnesium, vitamin C, and B vitamins were the most frequently supplemented micronutrients. The reasons for using, place of purchase, and source of information regarding dietary supplements significantly varied among students of different fields of study. Adverse effects related to dietary supplement use, including gastrointestinal symptoms, skin flushing, dizziness, and heart palpitation, were reported in 4.5% of students. Insufficient knowledge about these products was self-reported by 16.5% of users, more common among non-medical students. Thus, public health interventions are needed to improve students’ knowledge regarding rational and safe dietary supplement use.
... This antiinflammatory property makes PUFA useful in the prevention and treatment of COVID-19 cytokine storms. 186 There is an ongoing RCT on the efficacy of using Omega-3 Polyunsaturated Fatty Acids to combat cytokine storms in COVID-19 patients. It is a single-blinded, randomized, placebo-controlled study involving 40 participants. ...
The COVID-19 pandemic constitutes an arduous global health challenge, and the increasing number of fatalities calls for the speedy pursuit of a remedy. This review emphasizes the changing aspects of the COVID-19 disease, featuring the cytokine storm's pathological processes. Furthermore, we briefly reviewed potential therapeutic agents that may modulate and alleviate cytokine storms. The literature exploration was made using PubMed, Embase, MEDLINE, Google scholar, and China National Knowledge Infrastructure databases to retrieve the most recent literature on the etiology, diagnostic markers, and the possible prophylactic and therapeutic options for the management of cytokine storm in patients hospitalized with COVID-19 disease. The causative agent, severe acute respiratory coronavirus-2 (SARS-CoV-2), continually threatens the efficiency of the immune system of the infected individuals. As the first responder, the innate immune system provides primary protection against COVID-19, affecting the disease's progression, clinical outcome, and prognosis. Evidence suggests that the fatalities associated with COVID-19 are primarily due to hyper-inflammation and an aberrant immune function. Accordingly, the magnitude of the release of pro-inflammatory cytokines such as interleukin (IL)-1, (IL-6), and tumor necrosis alpha (TNF-α) significantly differentiate between mild and severe cases of COVID-19. The early prediction of a cytokine storm is made possible by several serum chemistry and hematological markers. The prompt use of these markers for diagnosis and the aggressive prevention and management of a cytokine release syndrome is critical in determining the level of morbidity and fatality associated with COVID-19. The prophylaxis and the rapid treatment of cytokine storm by clinicians will significantly enhance the fight against the dreaded COVID-19 disease.
... One of the proposed mechanisms was an inflammatory response to obstructive sleep apnea (OSA), i.e., mediating by cytokines, such as tumor necrosis factor (TNF-α) (15) and interleukin 6 (IL-6) (34). Animal and human studies have shown that the production of cytokines can be reduced by omega-3 PUFAs (35)(36)(37). However, the causal association between cytokines and SA was not evident. ...
Background
Previous observational studies have found that lower levels of circulating polyunsaturated fatty acids (PUFAs) were associated with a higher risk of sleep apnea (SA). However, the causality of the association remains unclear.Materials and methodsWe used the two-sample Mendelian randomization (MR) study to assess the causal association of omega-3 and omega-6 fatty acids with SA. Single-nucleotide polymorphisms (SNPs) predicting the plasma level of PUFAs at the suggestive genome-wide significance level (p < 5 × 10–6) were selected as instrumental variables (IVs) from the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) (n = ∼8,000) Consortium. For outcomes, the summary-level statistics of SA were obtained from the latest genome-wide association study (GWAS), which combined five cohorts with a total number of 25,008 SA cases and 172,050 snoring cases (total = 523,366).ResultsWe found no association of α-linolenic acid (ALA) [odds ratio (OR) = 1.09 per% changed, 95% confidence interval (CI) 0.67–1.78], eicosapentaenoic acid (EPA) (OR = 0.94, 95% CI 0.88–1.01), docosapentaenoic acid (DPA) (OR = 0.95, 95% CI 0.88–1.02), and docosahexaenoic acid (DHA) (OR = 0.99, 95% CI 0.96–1.02) with the risk of SA using inverse-variance weighted (IVW) method. Moreover, for omega-6 PUFAs, no association between linoleic acid (LA) (OR = 0.98, 95% CI 0.96–1.01), arachidonic acid (AA) (1.00, 95% CI 0.99–1.01), and adrenic acid (AdrA) (0.93, 95% CI 0.71–1.21) with the risk of SA was found. Similarly, no associations of PUFAs with SA were found in single-locus MR analysis.Conclusion
In the current study, we first found that there is no genetic evidence to support the causal role of omega-3 and omega-6 PUFAs in the risk of SA. From a public health perspective, our findings refute the notion that consumption of foods rich in PUFAs or the use of PUFAs supplementation can reduce the risk of SA.
... Furthermore, proinflammatory cytokines promote the secretion of corticotropin-releasing hormone (CRH), which is the main pathway of the hormonal stress response. CRH also stimulates the amygdala, which is a key brain area for fear and anxiety (56,57). An increasing number of dietary or nutrient-based interventions are investigated to be effective in preventing and managing psychiatric disorders (58). ...
Background:
Omega-3 polyunsaturated fatty acids (n-3 PUFAs) augmentation of antidepressants has shown great potential in the prevention and treatment of major depressive disorders (MDD).
Objective:
To investigate the effect of n-3 PUFAs plus venlafaxine in patients with first-diagnosed, drug-naïve depression.
Method:
A total of 72 outpatients with first-diagnosed depression were recruited. The daily dose of 2.4 g/day n-3 PUFAs or placebo plus venlafaxine was used for over 12 weeks. The outcomes were assessed by the Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), Beck depression inventory (BDI), and Self-rating anxiety scale (SAS).
Results:
Both groups exhibited improvement on clinical characteristics at week 4 and week 12 compared with baseline. The rate of responders for anxiety in n-3 PUFAs group (44.44%) was significantly higher than that in placebo group (21.21%) at week 4 (χ2 = 4.182, p = 0.041), while week 12 did not show a difference (χ2 = 0.900, p = 0.343). The rate of responders for depression at both week 4 (χ2 = 0.261, p = 0.609) and week 12 (χ2 = 1.443, p = 0.230) showed no significant difference between two groups. Further analysis found that Childhood Trauma Questionnaire (CTQ) had positive correlation with HAMA (r = 0.301, p = 0.012), SAS (r = 0.246, p = 0.015), HAMD (r = 0.252, p = 0.038) and BDI (r = 0.233, p = 0.022) with Pearson correlation analysis. Social Support Rating Scale (SSRS) had negative correlation with SAS (r = -0.244, p = 0.015) and BDI (r = -0.365, p = 0.000).
Conclusion:
This trial found that n-3 PUFAs supplementation in favor of venlafaxine alleviated the anxiety symptoms rather than depressive symptoms at the early stage of treatment (4 weeks) for first-diagnosed, drug-naïve depressed patients. However, the advantage disappeared in long-term treatment. Furthermore, childhood abuse and social support are closely related to the clinical and biological characteristics of depression. Both childhood trauma and lack of social support might be predictors of poor prognosis in depression.
Clinical trial registration:
[clinicaltrials.gov], identifier [NCT03295708].
... However, the incidence was quite lower in a modular diet enriched with the omega-3 fatty acid group. Since omega-3 fatty acids have potential anti-inflammatory actions by reducing immune responses, their benefits of immunomodulation have been explored in previous studies [33][34][35]. Considering the effects of omega-3 fatty acids on infection rates, it was shown that patients receiving omega-3 parenteral nutrition had a low risk of nosocomial infections [36]. In a previous study, clinical benefits such as lower rates of sepsis and GI complications due to a well-tolerated omega-3-fatty-acid-containing diet were well noted [21]. ...
Background:
In burn patients, the profound effect of nutritional support on improved wound healing and a reduced rate of hospitalization and mortality has been documented. Fish oil as a primary source of omega-3 fatty acids in nutritional support may attenuate the inflammatory response and enhance immune function; however, unclear effects on the improvement of clinical outcomes in burn patients remain.
Methods:
The systematic literature review was conducted by searching the electronic databases: Cochrane Library, PubMed, ScienceDirect, and Scopus to assess the randomized controlled trials of nutritional support with omega-3 fatty acids compared to control diets in patients that presented with burns from any causes.
Results:
Seven trials were included in this meta-analysis. We found no significant differences in length of stay (LOS) (p = 0.59), mortality (p = 0.86), ventilation days (p = 0.16), gastrointestinal complications-e.g., constipation and diarrhea (p = 0.73)-or infectious complications-e.g., pneumonia and sepsis (p = 0.22)-between the omega-3-fatty-acid-receiving group and the control/other diets group.
Conclusions:
We did not find a benefit of omega-3 support in reducing the various complications, mortality and LOS in burn patients. Further studies are necessary to find the effect of nutritional support with omega-3 fatty acids over low-fat diets in this population.
... A randomized controlled trial revealed that an increased ratio of n-6/n-3 PUFAs was associated with major depression and increased production of pro-inflammatory cytokines in students. This study found that lowering the n-6/n-3 PUFAs ratio resulted in lower anxiety and stimulated reductions in IL-6 and tumor necrosis factor alpha (TNF-α) production, as well as small differences in serum TNF-α (39). However, the interactions regarding n-3 and n-6 fatty acids in the context of inflammation are complex and still need to be justified by a large number of studies. ...
Objective
The aim of this systematic review and meta-analysis was to examine the association between high ratio of n-6/n-3 polyunsaturated fatty acids (PUFAs) and depression.
Methods
The authors conducted a meta-analysis of research articles on the association of high ratio of n-6/n-3 PUFAs with the risk of depression published in the online article database on PubMed, Embase, Cochrane library as of December 2021. Pooled odds ratios (OR) were calculated using random effects models. Publication bias was assessed visually by funnel plots and statistically by the Egger’s and Begg’s tests.
Results
Finally, 12 studies included in this systematic review and meta-analysis with a total of 66,317 participants (including 4,173 individuals with depression condition). The pooled results showed that high ratio of n-6/n-3 PUFAs might be positively associated with depression [OR = 1.21, 95% confidence intervals (CIs): 1.04∼1.41]. The I ² test indicated that there was a substantial statistical heterogeneity across the included studies ( I ² = 54.38%, P = 0.01). Subgroup analysis showed that high ratio of n-6/n-3 PUFAs in blood had no significant association with depression (OR = 1.15, 95%CI: 0.88∼1.50), while high ratio of n-6/n-3 PUFAs in dietary supplements was positively associated with depression (OR = 1.32, 95%CI: 1.16∼1.51).
Conclusion
This meta-analysis confirmed the association between high ratio of n-6/n-3 PUFAs and the risk of depression. High ratio of n-6/n-3 PUFAs in dietary supplementation was positively associated with depression, but had no significant association in the blood. This study suggested that lowering the dietary intake of the ratio of n-6/n-3 PUFAs would be beneficial in the prevention of depression.
... Unlike MDD, it is not as common to use n-3 PUFAs as an intervention for anxiety disorders. Although some meta-analyses show that n-3 PUFAs supplementation has the effect in preventing anxiety symptoms in certain circumstances, such as substance abusers (Buydens-Branchey & Branchey, 2006), patients with acute myocardial infarction (Haberka et al., 2013), and in medical students (Kiecolt-Glaser et al., 2011), another meta-analysis of clinical randomized trials did not support the prevention effect of n-3 PUFAs in anxiety disorders (Deane et al., 2021). Therefore, we currently can only conclude that the effects of n-3 PUFAs as treatments in anxiety disorders may be dose-dependent and should be indicated for individuals with specific anxiety disorder diagnoses, while the exact dosage warrants future investigation. ...
Essential fatty acids such as omega-3 polyunsaturated fatty acids (n-3 PUFAs) and omega-6 (n-6) PUFAs are essential for the development and function of the brain. There are three potential mechanisms that link n-3 PUFAs and mental health: (1) Inflammation & Oxidative Stress (2) Microbiota & Immune System (3) Nervous System. In addition, n-3 PUFAs have been used as a treatment for several common psychiatric disorders, including depression, anxiety disorders, attention-deficit/hyperactivity disorder (ADHD), and dementia. This chapter provides a brief overview of the most updated basic and clinical research findings of n-3 PUFAs in psychiatric disorders. Last but not least, clinical guidelines and the level of evidence of n-3 PUFAs in psychiatric disorders will also be featured in the chapter.
... There are substantial evidence that n-3 can relief symptoms of affective-emotional disorders (100,116). In fact, n-3 was able to partly decrease the anxiety-like behavior in NTG-injected rats, as evidenced by the lack of significant difference in the percentage of time spent in open arms between HFD n-3 treated NTG-free rats and their n-3 treated NTG-injected counterparts, while there was a significant difference between HFD n-3-free control rats and HFD n-3-free NTG-injected rats. ...
Background:
Migraine is a highly disabling disease, for which current therapies are limited to symptom alleviation. There is compelling evidence linking migraine with metabolic disorders, but the causal relationship is not clear. Omega-3 (n-3) fatty acids have anti-inflammatory properties, with clear benefits in metabolic disorders, but its effects on migraine remains to be tested. We hypothesized that fructose-induced metabolic syndrome could aggravate migraine by increasing neuroinflammation and that n-3 treatment could mitigate it.
Methods:
Male Wistar rats were used. Animals that received 10% high fructose diet (HFD) or tap water were subdivided into two additional groups: with or without n-3 supplementation. Fifteen days before euthanasia, each group was subdivided into two additional groups: with or without nitroglycerin (NTG)-induced migraine.
Results:
HFD lessened the migraine-like painful symptoms, as indicated by decreased grimace scores, which paralleled with reduced CGRP and leptin serum levels, increased hypothalamic CGRP, and decreased hypothalamic adiponectin and IL-6. There was a recovery of body and adipose tissue weight, besides a reduction of crown-like structures (CLS) in the inguinal adipose tissue. N-3 supplementation had no effect on NTG-related pain, but it decreased body and adipose tissue weight of HFD and tap water NTG-injected rats. N-3 improved NTG-related affective behavior and inflammatory parameters in tap water NTG-injected rats, with decreased hypothalamic TNF, serum CGRP and inguinal adipose-tissue CLS.
Conclusions:
HFD relieved NTG-induced pain, possibly due to decreased energy expenditure, minimizing migraine energy needs. N-3 exhibited favorable effects regarding affective behavior and central and peripheral inflammation, irrespective of HFD.
... The eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are part of the family of omega-3 from marine origin, while alpha-linolenic acid (ALA) is found mainly in plant oils. Omega-3 is widely used to treat or prevent different pathologies, such as diabetes [8], depression [9], and anxiety [10]. A recent study found some preclinical evidence about omega-3 and its metabolites in modulating underlying pathways related to complications secondary to cancer. ...
Omega-3 fatty acids are bioactive nutrients with the potential to preserve lean body mass in individuals with cancer. This study aimed to review the literature on randomized clinical trials that evaluated the effects of omega-3 supplementation on lean body mass in cancer patients. As secondary objectives, we evaluated the effects of omega-3 supplementation on body mass index (BMI) and body weight. We conducted a systematic review and meta-analysis in the following databases: Pubmed, LILACS, Scielo, Scopus, Web of Science, Cochrane, and Embase. It included randomized clinical trials that investigated the effects of omega-3 supplementation on lean body mass in cancer patients. Observational studies, animal experiments, studies carried out with healthy humans, and non-randomized clinical trials were excluded. We utilized the Cochrane scale to assess the quality of the studies. A meta-analysis was carried out to evaluate the effect of omega-3 on lean body mass, BMI, and body weight. Fourteen studies were included, of which four showed significant results from omega-3 supplementation for lean body mass. In the meta-analysis, omega-3 fatty acids increased lean body mass by 0.17 kg compared to placebo, but without significant differences between the groups [SMD: 0.17; CI 95%: −0.01, 0.35; I2 = 41%]. For body weight, omega-3 showed a statistically significant effect [SMD: 0.26; CI 95%: 0.06, 0.45; I2 = 46%], whereas for BMI the results were not significant. This systematic review and meta-analysis showed no statistically significant effect from omega-3 on lean body mass and BMI. On the other hand, there was a statistical significance for body weight.
... However, TL does not seem to be affected by daily energy intake, dietary fat, proteins and carbohydrates [64]. The differential dietary impacts of these macronutrients on TL shade light on the possibility that polyunsaturated acids have differential contributions towards influencing inflammatory processes [65][66][67], which may play a role in controlling telomere attrition. Moreover, it appears that the effects of these macronutrients may be different depending on gender, population or disease status of the experimental groups studied. ...
Telomeres play a critical role in maintaining cellular fate through tight regulation of cell division and DNA damage or repair. Over the years, it is established that biological ageing is defined by a gradual derangement in functionality, productivity, and robustness of biological processes. The link between telomeres and ageing is highlighted when derangement in telomere biology often leads to premature ageing and concomitant accompaniment of numerous age-associated diseases. Unfortunately, given that ageing is a biologically complicated intricacy, measures to reduce morbidity and improve longevity are still largely in the infancy stage. Recently, it was discovered that dietary habits and interventions might play a role in promoting successful healthy ageing. The intricate relationship between dietary components and its potential to protect the integrity of telomeres may provide unprecedented health benefits and protection against age-related pathologies. This review aims to summarise recent findings that investigate the roles of nutrition on telomere biology and provide enough evidence for further studies to consider the topic of nutrigenomics and its contributions toward healthy ageing and concomitant strategy against age-associated diseases.
... Inflammatory processes have been connected to the pathophysiology of depression and stressful conditions. Accordingly, administering omega-3 to students before a test lowers interleukin-6 levels by 14% and anxiety symptoms by 20% [34]. Furthermore, students' examrelated anxiety has been proven to be reduced by time management training [35]. ...
Background: Exam-related anxiety is a set of responses that include excessive worry, depression, nervousness, and irrelevant thinking from an individual's experience of assessment or testing and its outcome. Aim: This study was designed to evaluate exam-related anxiety among medical students in Baghdad City. Methods: This study utilized a cross-sectional survey design and was conducted by administering an online questionnaire to medical students (medicine, dentistry, and pharmacy). Results: A total of 530 students participated in the survey; 20.8% of them came from medical colleges, 41.7% from dentistry schools, and 37.5% from pharmacy schools. Around 27.1% of the respondents reported positive test-related anxiety. Conclusion: Exam-related anxiety is frequent among Iraqi medical students in Baghdad and highlights the need for education programs to reduce this anxiety.
... Inflammatory processes have been connected to the pathophysiology of depression and stressful conditions. Accordingly, administering omega-3 to students before a test lowers interleukin-6 levels by 14% and anxiety symptoms by 20% [34]. Furthermore, students' examrelated anxiety has been proven to be reduced by time management training [35]. ...
Background: Exam-related anxiety is a set of responses that include excessive worry, depression, nervousness, and irrelevant thinking from an individual's experience of assessment or testing and its outcome. Aim: This study was designed to evaluate exam-related anxiety among medical students in Baghdad City. Methods: This study utilized a cross-sectional survey design and was conducted by administering an online questionnaire to medical students (medicine, dentistry, and pharmacy). Results: A total of 530 students participated in the survey; 20.8% of them came from medical colleges, 41.7% from dentistry schools, and 37.5% from pharmacy schools. Around 27.1% of the respondents reported positive test-related anxiety. Conclusion: Exam-related anxiety is frequent among Iraqi medical students in Baghdad and highlights the need for education programs to reduce this anxiety.
We aimed to investigate the effectiveness of omega-3 fatty acids supplementation on the risk of developing depression, depressive symptoms and remission of depression. We searched PubMed, Scopus, and Web of Science from inception to December 2022 to find randomized trials of omega-3 fatty acids supplementation in adults. We conducted random-effects meta-analyses to estimate standardized mean differences (SMD) and 95% confidence intervals (CIs) for continuous outcomes and risk difference and 95%CI for binary outcomes. A total of 67 trials were included. Each 1 g/d omega-3 fatty acids supplementation significantly improved depressive symptoms in adults with and without depression (moderate-certainty evidence), with a larger improvement in patients with existing depression. Dose-response analyses indicated a U shaped effect in patients with existing depression, with the greatest improvement at 1.5 g/d. The analysis showed that omega-3 fatty acid supplementation significantly increased depression remission by 19 more per 100 in patients with depression (low-certainty evidence). Supplementation with omega-3 fatty acids did not reduce the risk of developing depression among the general population, but it did improve the severity of depression among patients with existing depression.
Neuropsychiatric disorders (NPDs) are considered a potential threat to mental health. Inflammation predominantly plays a role in the pathophysiology of NPDs. Dietary patterns are widely postulated to be involved in the physiological response to inflammation. This review aims to discuss the literature on how dietary inflammatory index (DII) is related to inflammation and, consequently, NPDs. After comprehensive scrutiny in different databases, the articles that investigated the relation of DII score and various NPDs and psychological circumstances were included. The association between dietary patterns and mental disorders comprising depression, anxiety, and stress proved the role of a proinflammatory diet in these conditions' exacerbation. Aging is another condition closely associated with DII. The impact of proinflammatory and anti-inflammatory diet on sleep quality indicated related disorders like sleep latency and day dysfunctions among the different populations are in relation with the high DII score. The potential effects of genetic backgrounds, dietary patterns, and the gut microbiome on DII are discussed as well. To plan preventive or therapeutic interventions considering the DII, these factors, especially genetic variations, should be considered as there is a growing body of literature indicating the role of personalized medicine in different NPDs. To the best of our knowledge, there is a limited number of RCTs on this subject, so future research should evaluate the causality via RCTs and look for therapeutic interventions with an eye on personalized medicine using information about DII in NPDs.
Objective:
There is mixed evidence about whether omega-3 fatty acids reduce depressive symptoms. We previously reported that 4 months of omega-3 supplementation reduced inflammatory responsivity to a lab-based social stressor. In another study, we showed that those with exaggerated inflammatory responsivity to a social stressor had the greatest depressive symptom increases over time, especially if they experienced frequent social stress. Here we tested whether omega-3 supplementation reduced subthreshold depressive symptoms among those who experienced frequent social stress.
Method:
Healthy, sedentary, generally overweight middle-aged and older adults (N = 138) were randomly assigned to 4 months of pill placebo (n = 46), 1.25 grams per day (g/d) omega-3 (n = 46), or 2.5 g/d omega-3 (n = 46). At a baseline visit and monthly follow-up visits, they reported depressive symptoms and had their blood drawn to assess plasma levels of omega-3 fatty acids. Participants completed the Trier Inventory of Chronic Stress at Visit 2 and the Test of Negative Social Exchange at Visit 3.
Results:
Among those who were overweight or obese, both doses of omega-3 reduced depressive symptoms only in the context of frequent hostile interactions and social tension, and 2.5 g/d of omega-3 lowered depressive symptoms among those with less social recognition or more performance pressure (ps < .05). Findings were largely corroborated with plasma omega-3 fatty acids. No other social stress or work stress measure moderated omega-3 fatty acids' relationship with depressive symptoms (ps > .05).
Conclusions:
Omega-3 fatty acids' antidepressant effect may be most evident among those who experience frequent social stress, perhaps because omega-3 fatty acids reduce inflammatory reactivity to social stressors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Introduction:
Omega-3 supplements may be efficacious in reducing symptoms of depression and anxiety in adults, particularly as an adjunct to antidepressant medication. However, research in young people is limited. Thus, this scoping review aimed to summarise existing evidence on the efficacy of omega-3 supplementation in treating depression and anxiety symptoms in young people aged 14-24. A secondary aim was to determine whether grey literature intended for the general public accurately reflects the evidence.
Method:
Four databases (Cochrane CENTRAL, EmBASE, PsycINFO, PubMed) were searched from inception to 4th August 2021. Eligible peer-reviewed studies were empirical studies which examined the efficacy of omega-3 supplements in preventing/treating anxiety and/or depression symptoms in young people aged 14-24. Risk of bias was assessed for randomised studies using the Cochrane Risk of Bias Tool. Selected grey literature databases were also searched, with eligible sources assessed for quality. A stakeholder group including young people with lived experience of anxiety/depression, parents/carers and mental health professionals informed the research questions and data interpretation. Findings were summarised using narrative synthesis.
Results:
17 empirical studies (N = 1240 participants) meeting inclusion criteria were identified. Studies varied in treatment and participant characteristics. In general, the data did not support the view that omega-3 supplements were efficacious in improving symptoms of anxiety or depression in young people aged 14-24. In contrast, most grey literature sources recommended the use of omega-3 supplements in young people.
Discussion:
Evidence for efficacy of omega-3 supplementation in reducing symptoms of depression and anxiety in young people was inconclusive. More research is needed to identify potential mechanisms and moderators of the effect of omega-3 supplements on depression and anxiety symptoms in young people.
Background:
Chronic inflammation perturbations during pregnancy may impact fetal growth; however, research on the association between dietary inflammation and birth outcomes is limited and inconsistent.
Objectives:
This study seeks to assess whether the dietary inflammatory potential is related to birth outcomes among pregnant women in China.
Methods:
A total of 7194 mothers aged 17-46 y and their infants in China were included in this cross-sectional study. Dietary intake was assessed by a FFQ, which yielded scores on the energy-adjusted dietary inflammatory index (E-DII). Birth outcomes included birth weight, gestational age, birth weight z score, low birth weight (LBW), macrosomia, preterm birth, small-for-gestational-age (SGA), large-for-gestational-age (LGA), and birth defects. Generalized estimating equation and restricted cubic spline fit each outcome on continuous or quartiles of E-DII after adjusting for covariates.
Results:
The maternal E-DII ranged from -5.35 to 6.77. Overall, birth weight and gestation age (mean ± SD) were 3267.9 ± 446.7 g and 39.6 ± 1.3 wk, respectively, and the birth weight z score was 0.02 ± 1.14. A total of 3.2% of infants were born with LBW, 6.1% with macrosomia, 3.0% were preterm birth, 10.7% were born SGA, 10.0% were born LGA, and 2.0% were born with birth defects. E-DII was associated with a 9.8 g decrease in birth weight (95% CI: -16.9, -2.6) and a 1.09-fold (95% CI: 1.01, 1.18), 1.11-fold (95% CI: 1.02, 1.21), and 1.12-fold (95% CI: 1.02, 1.24) greater risk of LBW, preterm birth, and birth defects, respectively. The maternal E-DII score was nonlinearly associated with gestational age (P for linearity = 0.009, P for curvature = 0.044).
Conclusions:
Among pregnant Chinese women, proinflammatory diets during pregnancy were related to reduced offspring birth weight and an increased risk of LBW, preterm birth, and birth defects. These findings might inform potential prevention strategies for pregnant women in China.
Background:
The emerging research in the literature continues to forecast a drastic and alarming increase in negative mental health and sleep health outcomes among populations, especially after the COVID-19 pandemic, which significantly influenced people's way of life. With mental health pharmaceutical interventions continuing to be stigmatized and inaccessible among populations, natural supplements provide an opportunity for intervention.
Objective:
This study sought to conduct a systematic review of the literature on the most recent comprehensive evidence for which nutritional supplements have the greatest therapeutic impact on symptoms of anxiety, depression, and insomnia.
Methods:
A systematic search of the literature, utilizing several databases, including PubMed and Web of Science, was conducted on 29 April 2022. We used developed keywords and MeSH terms for the search. The study eligibility criteria included (1) a randomized control trial; (2) investigating a plant-based therapeutic or natural supplement as the intervention; (3) measuring at least one health outcome of the following: anxiety symptoms, depressive symptoms, or sleep health outcomes; (4) utilizing validated measurement tools to measure the outcome of interest; (5) written in the English language; (6) peer reviewed; and (7) focused on adults and elderly populations.
Main results:
Following the PRISMA guidelines, 76 studies were included in this review. We used the revised Risk of Bias tool (RoB2) to assess the quality of all included randomized control trials. A qualitative data synthesis was conducted. Overall, we found several valuable insights from the evidence in the literature, including evidence that demonstrates the benefits of probiotics and vitamin B complexes on anxiety symptoms, depressive symptoms, and sleep quality. Implication of Key Findings: This review provides the most updated findings in the literature on the topic, including an abundance of research that was published in the past 5 years. Given the expected rise in negative mental and sleep health outcomes following the pandemic, the supplements and therapeutics identified in this study should be the target of intervention measures to increase their accessibility and affordability and allow them to be incorporated into clinical guidelines of treatment. PROSPERO registration number: CRD42022361130.
Adolescents are known to be more vulnerable than adults to the adverse effects of nicotine dependence. In the present study, we aimed to investigate whether adolescent nicotine exposure, followed by a period of abstinence, could affect the anxiety- and depressive-like behaviors in rats. For this purpose, behavioral assessments were carried out using open field test, elevated plus maze and forced swimming test in male rats received chronic nicotine intake during adolescence followed by a period of abstinence in adulthood, compared to their control counterparts. In addition, O3 pre-treatment was done at three different doses to reveal whether it could prevent nicotine withdrawal effects. Then, animals were euthanized and the cortical concentrations of oxidative stress markers, inflammatory indices, brain-derived neurotrophic factor, serotonin and the enzymatic activity of monoamine oxidase-A were measured. Results indicated that nicotine withdrawal exacerbates the behavioral signs of anxiety through alteration of the brain oxidative stress balance, inflammatory response and serotonin metabolism. Moreover, we found that omega 3 pre-treatment significantly prevents the nicotine withdrawal-induced complications by restoration of changes in the mentioned biochemical indices. Moreover, the improving effects of O3 fatty acids were found to be dose-dependent in all experiments. Taken together, we would like to suggest the O3 fatty acids supplementation as a safe, inexpensive and effective strategy for prevention or amelioration of detrimental effects induced by nicotine withdrawal at cellular and behavioral levels.
Everybody eats, and what we eat – or do not – affects the brain and mind. There is significant general, applied, academic, and industry interest about nutrition and the brain, yet there is much misinformation and no single reliable guide. Diet Impacts on Brain and Mind provides a comprehensive account of this emerging multi-disciplinary science, exploring the acute and chronic impacts of human diet on the brain and mind. It has a primarily human focus and is broad in scope, covering wide-ranging topics like brain development, whole diets, specific nutrients, research methodology, and food as a drug. It is written in an accessible format and is of interest to undergraduate and graduate students studying nutritional neuroscience and related disciplines, healthcare professionals with an applied interest, industry researchers seeking topic overviews, and interested general readers.
Inflammasomes are multiprotein intracellular complexes composed of innate immune system receptors and sensors; they activate the inflammatory cascade in response to infectious microbes and/or molecules derived from host proteins. Because of cytokine secretion, inflammasomes can induce amplified systemic responses, its dysregulation can exacerbate symptoms in infectious diseases, and it has been related to the development of autoimmune diseases, inflammatory disorders, and even cancer. Obesity is associated with a chronic low‐grade inflammation, in which circulating proinflammatory cytokines are elevated. Some publications describe changes in inflammation markers as a consequence of obesity, but others suggest that chronic inflammation might cause obesity (e.g., C‐reactive protein): these assumptions reflect the difficulty of identifying the appropriate role of inflammation as cause or consequence of obesity and its related complications. Obesity is recognized as a clinical risk factor for developing cardiovascular diseases including atherosclerosis, metabolic syndrome, insulin resistance, and diabetes mellitus. Changes in the expression of inflammasomes are described in some of these obesity‐related complications, and moreover, its modulation might exert a beneficial effect in some cases. Despite some contradictory results, most publications suggest a promising clinical effect based on in vitro and in vivo experiments. In this review, we summarized recent publications about inflammasome dysregulation in humans and its relationship with obesity‐related comorbidities.
When the external conditions change, such as the temperature or the pressure, the multi-component system sometimes separates into several phases with different components and structures, which is called phase separation. Increasing studies have shown that cells condense related biomolecules into independent compartments in order to carry out orderly and efficient biological reactions with the help of phase separation. Biomolecular condensates formed by phase separation play a significant role in a variety of cellular processes, including the control of signal transduction, the regulation of gene expression, and the stress response. In recent years, many phase separation events have been discovered in the immune response process. In this review, we provided a comprehensive and detailed overview of the role and mechanism of phase separation in the innate and adaptive immune responses, which will help the readers to appreciate the advance and importance of this field.
A healthy diet shapes a healthy mind. Diet quality has a strong association with brain health. Diet influences the onset and consequences of neurological diseases, and dietary factors may influence mental health at individual and population level. The link between unhealthy diet, impaired cognitive function and neu-rodegenerative diseases indicates that adopting a healthy diet would ultimately afford prevention and management of neurolog-ical diseases and brain aging. Neurodegenerative diseases are of multifactorial origin and result in progressive loss of neuronal function in the brain, leading to cognitive impairment and moto-neuron disorders. The so-called Mediterranean diet (MedDiet) with its healthy ingredients rich in antioxidant, anti-inflammatory, immune, neuroprotective, antidepressant, antistress and seno-lytic activity plays an essential role in the prevention and man-agement of neurological diseases and inhibits cognitive decline in neurodegenerative diseases such as Alzheimer’s, Parkinson’s and Huntington’s diseases. The MedDiet also modulates the gut-brain axis by promoting a diversity of gut microbiota. In view of the importance of diet in neurological diseases management, this review focuses on the dietary components, natural compounds and medicinal plants that have proven beneficial in neurological diseases and for brain health. Among them, polyphenols, omega-3 fatty acids, B vitamins and several ayurvedic herbs have promis-ing beneficial effects.
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.
The concept of social jetlag refers to asynchronous communication of a person's biological clock with tempo of modern living, which occurs mainly as a result of intensive work. At the core of social jetlag is sleep deprivation or chronic sleep restriction caused by social factors: pervasive use of electronic solutions and networks, intensive round the clock operation, chronic diseases. The aim of the work was to determine vitamins, minerals, and other micronutrients, the availability of which is important for supporting the organism in case of circadian rhythm sleep disorders and sleep restrictions, the so-called social jetlag. Material and methods. The analysis of 78 sources from PubMed and Google Scholar bibliographic bases was carried out with a detailed analysis of data from the published studies. Results. Circadian rhythm sleep disorders and sleep restrictions affects cognitive functions, increasing risk of anxiety and depressive disorders, enhances processes of chronic inflammation, oxidative stress, cardiometabolic disorders. Scientific evidence has been collected that lack of such elements as magnesium, folates, omega-3 polyunsaturated fatty acids and probiotics in diet can worsening effects of social jetlag and increase the risk of chronic diseases. Preventive course intake of this micronutrients is reasonable in people predisposed to social jetlag. Conclusion. In risk groups of people predisposed to social jetlag, along with diverse diet and adequate nutrition, sleep hygiene, it is necessary to provide targeted supplementation with magnesium, folates, omega-3 polyunsaturated fatty acids and probiotic products.
The debate over a role for n-3 long-chain polyunsaturated fatty acids (n-3 PUFAs) in depressed mood continues.
The objective was to update a previous systematic review and meta-analysis of published randomized controlled trials investigating the effects of n-3 PUFAs on depressed mood and to explore potential sources of heterogeneity.
Eight databases were searched for trials that randomly assigned participants to receive n-3 PUFAs/fish, measured depressed mood, used human participants, and included a comparison group up to April 2009.
Thirty-five randomized controlled trials were identified; 17 were not included in the previous review. The pooled standardized difference in mean outcome of the 29 trials that provided data to allow pooling (fixed-effects model) was 0.10 SD (95% CI: 0.02, 0.17) in those who received n-3 PUFAs compared with placebo, with strong evidence of heterogeneity (I(2) = 65%, P < 0.01). The presence of funnel plot asymmetry suggested that publication bias was a likely source of this heterogeneity. Depressive symptom severity and participant diagnosis also explained some of the observed heterogeneity. Greater effects of n-3 PUFAs were found in individuals with more-severe depressive symptoms. In trials that enrolled individuals with a diagnosed depressive disorder, the combined mean difference was 0.41 (95% CI: 0.26, 0.55), although evidence of heterogeneity was also found (I(2) = 71%). In trials that enrolled individuals without a depressive diagnosis, no beneficial effects of n-3 PUFAs were found (largest combined mean difference: 0.22; 95% CI: -0.01, 0.44; I(2) = 0%).
Trial evidence of the effects of n-3 PUFAs on depressed mood has increased but remains difficult to summarize because of considerable heterogeneity. The evidence available provides some support of a benefit of n-3 PUFAs in individuals with diagnosed depressive illness but no evidence of any benefit in individuals without a diagnosis of depressive illness.
The repeatability of a risk factor measurement affects the ability to accurately ascertain its association with a specific outcome. Choline is involved in methylation of homocysteine, a putative risk factor for cardiovascular disease, to methionine through a betaine-dependent pathway (one-carbon metabolism). It is unknown whether dietary intake of choline meets the recommended Adequate Intake (AI) proposed for choline (550 mg/day for men and 425 mg/day for women). The Estimated Average Requirement (EAR) remains to be established in population settings. Our objectives were to ascertain the reliability of choline and related nutrients (folate and methionine) intakes assessed with a brief food frequency questionnaire (FFQ) and to estimate dietary intake of choline and betaine in a bi-ethnic population.
We estimated the FFQ dietary instrument reliability for the Atherosclerosis Risk in Communities (ARIC) study and the measurement error for choline and related nutrients from a stratified random sample of the ARIC study participants at the second visit, 1990-92 (N = 1,004). In ARIC, a population-based cohort of 15,792 men and women aged 45-64 years (1987-89) recruited at four locales in the U.S., diet was assessed in 15,706 baseline study participants using a version of the Willett 61-item FFQ, expanded to include some ethnic foods. Intraindividual variability for choline, folate and methionine were estimated using mixed models regression.
Measurement error was substantial for the nutrients considered. The reliability coefficients were 0.50 for choline (0.50 for choline plus betaine), 0.53 for folate, 0.48 for methionine and 0.43 for total energy intake. In the ARIC population, the median and the 75th percentile of dietary choline intake were 284 mg/day and 367 mg/day, respectively. 94% of men and 89% of women had an intake of choline below that proposed as AI. African Americans had a lower dietary intake of choline in both genders.
The three-year reliability of reported dietary intake was similar for choline and related nutrients, in the range as that published in the literature for other micronutrients. Using a brief FFQ to estimate intake, the majority of individuals in the ARIC cohort had an intake of choline below the values proposed as AI.
We explored the expression of the interleukin 2 receptor (IL-2R) and the synthesis of IL-2R messenger RNA by peripheral blood leukocytes obtained from medical students experiencing examination stress in three independent studies. The peripheral blood leukocytes obtained at low-stress baseline periods had significantly higher percentages of IL-2R-positive cells when compared with cells obtained from the same individuals during examinations. In addition, IL2-R messenger RNA in peripheral blood leukocytes decreased significantly during examination periods in a subset of 13 subjects. In one study, we found an increase in the accumulation of interleukin 2 in cultures of cells showing down regulation of IL-2R expression and IL-2R messenger RNA levels. While there are ample data demonstrating stress-associated decrements in the immune response in humans and animals, these data provide the first evidence that this interaction may be observed at the level of gene expression. The data suggest one mechanism whereby the central nervous system modulates the immune response during psychological stress.
Eskimos living in rural southwestern Alaska depend on fish and marine mammals as major sources of subsistence food. Fatty acid concentrations in 80 Yupik Eskimos living in either a coastal or river village of southwestern Alaska were compared with those of non-Native control subjects. Concentrations of total plasma omega-3 fatty acids, eicosapentaenoic acid (20:5 omega-3), and docosahexaenoic acid (22:6 omega-3) were 4.3, 13, and 6.8 times higher, respectively, in Native participants than in non-Native control subjects. Concentrations of these fatty acids were higher in coastal-village than in river-village participants; concentrations paralleled consumption of marine mammal oil and marine fish. The ratios of eicosapentaenoic to arachidonic acid for adult coastal- and river-village participants were 1.16 and 0.70, respectively, 14 and 9 times those of non-Native adults, respectively. There was no increase in the mean bleeding times of Native participants of either village.
Fish contains high concentrations of omega-3 polyunsaturated fatty acids. Several studies have reported depletions of omega-3 fats among depressed patients, and a cross-national comparison has revealed a significant inverse correlation between annual prevalence of major depression and fish consumption. In a sample of 3,204 Finnish adults, depressive symptoms were estimated with the Beck Depression Inventory. A frequency question was used to measure fish consumption. Multiple logistic regression analysis was conducted to assess the association between depression and fish consumption. After the analysis adjusted for potential confounders, the likelihood of having depressive symptoms was significantly higher among infrequent fish consumers than among frequent consumers.
This book contains 18 chapters discussing the roles of specific nutrients in maintaining the immune response and protection against infection and non-communicable diseases, and the influence of various factors, such as exercise and aging, on the interaction between nutrition and immune function. The contents include methods for studying nutrient-immune function interactions, the impact of undernutrition on immune function and infection, the influences of fatty acids, amino acids, antioxidant vitamins, various minerals and probiotics on immunity, food allergies, immunological effects of changes throughout the life cycle, and public health policy implications.
Four methylation methods were evaluated for use in the gas chromatographic (GC) quantitation of conjugated linoleic acid (CLA) isomers, which are potential anticarcinogen. The methods were (1) sodium methoxide in methanol (NaOMe-MeOH), (2) American Oil Chemists' Society (AOCS) procedure Ce 2-66, which involves methanolic sodium hydroxide followed by boron trifluoride in methanol, (3) tetramethylguanidine in methanol (TMG-MeOH), and (4) direct transesterification with methanolbenzene- acetyl chloride (DAC). Purified methyl esters of isomerized linoleic acid containing 86% CLA isomers were methylated and analyzed by GC. The AOCS and DAC methods resulted in 3 and 50% losses in cis-9,trans-11-octadecadienoic acid (9c, 111 CLA isomer) and trans-10,cis-12 octadecadienoic acid (10t, 12c CLA isomers), respectively. Compared with the control, the AOCS and DAC methods increased the yield of the trans,trans CLA isomers (trans-9,trans-11- and trans-10, trans-12-octadecadienoic acid) by 1.07-fold and a 10-fold, respectively. A non-CLA artifact that eluted close to CLA peaks was formed during methylation by the AOCS and DAC methods. Thus, the DAC and AOCS methods are not suitable for quantitation of CLA isomers. The NaOMe-MeOH and TMG-MeOH methods, however, are suitable for quantitation of CLA isomers in fats containing low concentrations of free fatty acids.
Lipid decomposition studies in frozen fish have led to the development of a simple and rapid method for the extraction and purification of lipids from biological materials. The entire procedure can be carried out in approximately 10 minutes; it is efficient, reproducible, and free from deleterious manipulations. The wet tissue is homogenized with a mixture of chloroform and methanol in such proportions that a miscible system is formed with the water in the tissue. Dilution with chloroform and water separates the homogenate into two layers, the chloroform layer containing all the lipids and the methanolic layer containing all the non-lipids. A purified lipid extract is obtained merely by isolating the chloroform layer. The method has been applied to fish muscle and may easily be adapted to use with other tissues.
Studies which have investigated the influence of increased consumption of n-3 polyunsaturated fatty acids (PUFA) upon indices of immune function in healthy humans are reviewed. Four studies have investigated the effects of α-linolenic acid (ALNA; 2 to 18 g per day). Over 25 studies have investigated the effects of the long chain n-3 PUFA and these have used 0.55 to 14.4 g eicosapentaenoic acid (EPA) plus docosahexanoic acid (DHA) per day. Studies have been of 3 to 52 weeks duration. Most studies have examined the functions of immune cells ex vivo; there are a limited number of studies reporting in vivo measures of immune status/responses. High levels of either ALNA or EPA + DHA decrease chemotaxis of neutrophils and monocytes, production of reactive oxygen species by neutrophils and monocytes, production of pro-inflammatory cytokines by monocytes and T lymphocytes, and T lymphocyte proliferation. For most of these functions it is not possible to determine dose-response relationships because of experimental differences among studies. Thus, it is not clear what the level of n-3 PUFA required to exert the different effects is. The immunological effects of large amounts of n-3 PUFA suggest that they might be useful as therapies for diseases characterized by immune dysfunction. Evidence for beneficial effects of long chain n-3 PUFA in rheumatoid arthritis is strong and there is less strong evidence for benefit in Crohn’s disease, ulcerative colitis and psoriasis and among some adult asthmatics.
Background:
It has been hypothesized that depletion of cell membrane n3 polyunsaturated fatty acids (PUFA), particularly docosahexanoic acid (DHA), may be of etiological importance in depression.
Methods:
We measured the fatty acid composition of phospholipid in cell membranes from red blood cells (RBC) of 15 depressive patients and 15 healthy control subjects.
Results:
Depressive patients showed significant depletions of total n3 PUFA and particularly DHA. Incubation of RBC from control subjects with hydrogen peroxide abolished all significant differences between patients and controls.
Conclusions:
These findings suggest that RBC membranes in depressive patients show evidence of oxidative damage. Possible interpretations, and implications for the etiology and treatment of depression, are discussed.
Depression during pregnancy has adverse consequences for both mother and child. Although common in western countries, depression appears to be virtually absent in countries with high seafood intake. We test the hypothesis that low seafood intake during pregnancy is associated with increased prevalence of depressive symptoms.
This study used data prospectively collected from women participating in the Avon Longitudinal Study of Parents and Children in the period 1991-1992. At 32 weeks' gestation, the mother completed a questionnaire that included symptoms of depression and a food frequency questionnaire from which the amount of omega-3 fatty acids from fish was calculated. Statistical analysis took social and lifestyle factors into account.
Unadjusted and adjusted analyses showed lower maternal intake of omega-3 from seafood was associated with high levels of depressive symptoms. Compared with women consuming more than 1.5 g omega-3 from seafood per week, those consuming none were more likely to have high levels of depressive symptoms at 32 weeks' gestation (adjusted odds ratios = 1.54; 95% confidence interval = 1.25-1.89).
These observational data support an association between low omega-3 intake from seafood and increased risk of high levels of depressive symptoms during pregnancy. Eating seafood during pregnancy may have beneficial effects on mental well-being.
The CES-D scale is a short self-report scale designed to measure depressive symptomatology in the general population. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. The new scale was tested in household interview surveys and in psychiatric settings. It was found to have very high internal consistency and adequate test- retest repeatability. Validity was established by pat terns of correlations with other self-report measures, by correlations with clinical ratings of depression, and by relationships with other variables which support its construct validity. Reliability, validity, and factor structure were similar across a wide variety of demographic characteristics in the general population samples tested. The scale should be a useful tool for epidemiologic studies of de pression.
Some prospective studies have shown an inverse association between fish intake and risk of stroke, but none has examined the relationship of fish and omega-3 polyunsaturated fatty acid intake with risk of specific stroke subtypes.
To examine the association between fish and omega-3 polyunsaturated fatty acid intake and risk of stroke subtypes in women.
Prospective cohort study of women in the Nurses' Health Study cohort, aged 34 to 59 years in 1980, who were free from prior diagnosed cardiovascular disease, cancer, and history of diabetes and hypercholesterolemia and who completed a food frequency questionnaire including consumption of fish and other frequently eaten foods. The 79 839 women who met our eligibility criteria were followed up for 14 years.
Relative risk of stroke in 1980-1994 compared by category of fish intake and quintile of omega-3 polyunsaturated fatty acid intake.
After 1 086 261 person-years of follow-up, 574 incident strokes were documented, including 119 subarachnoid hemorrhages, 62 intraparenchymal hemorrhages, 303 ischemic strokes (264 thrombotic and 39 embolic infarctions), and 90 strokes of undetermined type. Among thrombotic infarctions, 90 large-artery occlusive infarctions and 142 lacunar infarctions were identified. Compared with women who ate fish less than once per month, those with higher intake of fish had a lower risk of total stroke: the multivariate relative risks (RRs), adjusted for age, smoking, and other cardiovascular risk factors, were 0.93 (95% confidence interval [CI], 0.65-1.34) for fish consumption 1 to 3 times per month, 0.78 (95% CI, 0.55-1.12) for once per week, 0.73 (95% CI, 0.47-1.14) for 2 to 4 times per week, and 0.48 (95% CI, 0.21-1.06) for 5 or more times per week (P for trend =.06). Among stroke subtypes, a significantly reduced risk of thrombotic infarction was found among women who ate fish 2 or more times per week (multivariate RR, 0.49; 95% CI, 0.26-0.93). Women in the highest quintile of intake of long-chain omega-3 polyunsaturated fatty acids had reduced risk of total stroke and thrombotic infarction, with multivariate RRs of 0.72 (95% CI, 0.53-0.99) and 0.67 (95% CI, 0.42-1.07), respectively. When stratified by aspirin use, fish and omega-3 polyunsaturated fatty acid intakes were inversely associated with risk of thrombotic infarction, primarily among women who did not regularly take aspirin. There was no association between fish or omega-3 polyunsaturated fatty acid intake and risk of hemorrhagic stroke.
Our data indicate that higher consumption of fish and omega-3 polyunsaturated fatty acids is associated with a reduced risk of thrombotic infarction, primarily among women who do not take aspirin regularly, but is not related to risk of hemorrhagic stroke.
overview measures of depression provides brief descriptions of each measure and summarizes the available psychometric data / the measures fall into the following categories: structured diagnostic interviews, clinician rating scales, global illness ratings, and self-report instruments
what to measure / requirements of measures / target populations / survey of measures / related domains / when to measure (PsycINFO Database Record (c) 2012 APA, all rights reserved)
D van West, M Maes. Polyunsaturated fatty acids in depression.
SUMMARY Increasingly, there is a need in both research and clinical practice to document and quantify sleep and waking behaviors in a comprehensive manner. The Pittsburgh Sleep Diary (PghSD) is an instrument with separate components to be completed at bedtime and waketime. Bedtime components relate to the events of the day preceding the sleep, waketime components to the sleep period just completed. Two-week PghSD data is presented from 234 different subjects, comprising 96 healthy young middle-aged controls, 37 older men, 44 older women, 29 young adult controls and 28 sleep disorders patients in order to demonstrate the usefulness, validity and reliability of various measures from the instrument. Comparisons are made with polysomnographic and actigraphic sleep measures, as well as personality and circadian type questionnaires. The instrument was shown to have sensitivity in detecting differences due to weekends, age, gender, personality and circadian type, and validity in agreeing with actigraphic estimates of sleep timing and quality. Over a 12–31 month delay, PghSD measures of both sleep timing and sleep quality showed correlations between 0.56 and 0.81 (n= 39, P < 0.001).
The mechanisms of stress-related immune alterations have not been fully elucidated. Cell-mediated immune responses as well as antibody and certain cytokines are reported as being suppressed during times of high stress. However, the role of suppression vs dysregulation has not been established in human stress models. The effect of exam stress on regulatory cytokines in 16 healthy medical students was assessed by measuring type-1 (IFN-γ) and type-2 (IL-10) cytokines from 72-h PHA/PMA-stimulated PBMC 4 weeks before and 48 h after exams. Results demonstrated decreased IFN-γ accompanied by increased IL-10 during exam stress that resulted in a decreased IFN-γ:IL-10 ratio. There was a significant correlation between the cytokine response to PHA/PMA and number and subjective adjustment to daily hassles. Additionally, students who reported greater levels of loneliness also reported greater numbers of and poorer subjective adjustment to hassles. The differences were consistent in both males and females but did not correlate with AM cortisol levels. Additionally, when individuals were grouped into high vs low preexam hassle levels, the type-1/type-2 shift in the IFN-γ:IL-10 ratio occurred in the low hassles group only. These data suggest that psychologically stressful situations shift type-1/type-2 cytokine balance toward type-2 and result in an immune dysregulation rather than overall immunosuppression. This may partially explain the increased incidence of type-2-mediated conditions such as increased viral infections, latent viral expression, allergic/asthmatic reactions, and autoimmunity reported during periods of high stress.
The development of a 21-item self-report inventory for measuring the severity of anxiety in psychiatric populations is described. The initial item pool of 86 items was drawn from three preexisting scales: the Anxiety Checklist, the Physician’s Desk Reference Checklist, and the Situational Anxiety Checklist. A series of analyses was used to reduce the item pool. The resulting Beck Anxiety Inventory (BAI) is a 21-item scale that showed high internal consistency (α = .92) and test—retest reliability over 1 week, r (81) = .75. The BAI discriminated anxious diagnostic groups (panic disorder, generalized anxiety disorder, etc.) from nonanxious diagnostic groups (major depression, dysthymic disorder, etc). In addition, the BAI was moderately correlated with the revised Hamilton Anxiety Rating Scale, r (150) = .51, and was only mildly correlated with the revised Hamilton Depression Rating Scale, r (153) = .25.
A growing body of evidence indicates that patients with immune-inflammatory diseases experience an increased risk for cardiovascular morbidity and mortality. However, patients with immune-inflammatory diseases do not exhibit a corresponding increase in traditional coronary artery disease (CAD) risk factors that could explain the observed increase in CAD. Chronic inflammation is now accepted as playing a potentially important role in the promotion of atherosclerosis, a main cause of CAD. Evidence is also accumulating to suggest that the chronic systemic inflammation associated with immune-inflammatory diseases results in elevated levels of nontraditional CAD risk factors, such as biomarkers of inflammation, in patients with these conditions. Evaluation of only traditional CAD risk factors in these patients, therefore, may result in the underestimation of their future overall CAD risk. Using the Framingham patient cohort, we found associations between markers of inflammation and CAD risk overall. The contribution of inflammatory biomarkers should be considered along with the status of traditional CAD risk factors to gain a complete picture of the CAD risk in patients with underlying conditions that increase inflammation such as rheumatoid arthritis or systemic lupus erythematosus.
To address how interactions between polyunsaturated fatty acid (PUFA) levels and depressive symptoms were related to proinflammatory cytokine synthesis. Depression and stress promote proinflammatory cytokine production. Dietary intakes of omega-3 (n-3) and omega-6 (n-6) PUFAs also influence inflammation; high n-6:n-3 ratios enhance proinflammatory cytokine production, although n-3 has anti-inflammatory properties.
Blood samples from 43 older adults (mean age = 66.67 years, SD = 10.09) provided data on PUFAs and tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, and IL-6 soluble receptor (sIL-6r). Depressive symptoms were assessed by the Center for Epidemiological Studies Depression Scale.
Depressive symptoms and n-6:n-3 ratios worked together to enhance proinflammatory cytokines beyond the contribution provided by either variable alone, with substantial variance explained by their interaction: 13% for IL-6 and 31% for TNF-alpha, whereas full models accounted for 18% and 40%, respectively. Although predicted cytokine levels were consistent across n-6:n-3 ratios with low depressive symptoms, higher n-6:n-3 ratios were associated with progressively elevated TNF-alpha and IL-6 levels as depressive symptoms increased. Higher levels of sIL-6r were associated with higher n-6:n-3 ratios. Six individuals who met the criteria for major depressive disorder had higher n-6:n-3 ratios and TNF-alpha, IL-6, and sIL-6r levels than those who did not meet the criteria; excluding these six individuals reduced the variance explained by the depressive symptoms and n-6:n-3 ratio interaction.
Diets with high n-6:n-3 PUFA ratios may enhance the risk for both depression and inflammatory diseases.
The n-6 and n-3 polyunsaturated fatty acids (PUFAs) are essential nutrients; intake of relatively small amounts of these fatty acids prevents nutritional deficiencies. Replacing dietary saturated fat with PUFAs may confer health gains. Experimental data support the notion that high intake of n-6 PUFAs may increase in vivo lipid peroxidation. This effect may be counteracted by dietary antioxidant supplementation. The influence of a high n-3 PUFA intake on measures of lipid peroxidation has been equivocal. In clinical trials, subjects who consumed diets rich in n-6 or n-3 PUFAs had fewer atherothrombotic endpoints than did control groups. In this report, data regarding the influence of PUFAs on lipid peroxidation as well as on cholesterol and glucose metabolism, hemostasis, and other aspects of interest are reviewed and discussed. Currently, daily intake of PUFAs as >10% of total energy is not recommended. Below this ceiling there is little evidence that high dietary intake of n-6 or n-3 PUFAs implies health risks.
Epidemiologic studies of fish consumption in relation to risk of stroke have yielded inconsistent results.
In this study, we examined the association between fish consumption and stroke incidence in women.
We analyzed data from a population-based prospective cohort of 34,670 women in the Swedish Mammography Cohort who were free of cardiovascular disease and cancer at baseline. Information on fish consumption was obtained by a self-administered questionnaire in 1997. Incident cases of stroke were ascertained from the Swedish Hospital Discharge Registry. We used Cox proportional hazards regression to estimate relative risks (RRs) and 95% CIs.
Over a mean follow-up of 10.4 y, we ascertained 1680 incident cases of stroke, including 1310 cerebral infarctions, 233 hemorrhagic strokes, and 137 unspecified strokes. Fish consumption was significantly inversely associated with risk of total stroke but not with cerebral infarction or hemorrhagic stroke. Compared with women in the lowest quintile of fish consumption (<1.0 serving of fish/wk), the multivariable RR of total stroke for women in the highest quintile (>3.0 servings of fish/wk) was 0.84 (95% CI: 0.71, 0.98; P for trend = 0.049). Consumption of lean fish but not of other fish types was inversely associated with risk of stroke. The multivariable RR of total stroke was 0.67 (95% CI: 0.49, 0.93; P for trend = 0.07) for ≥3 servings of lean fish/wk compared with that for no consumption.
These results suggest that the consumption of fish, especially of lean fish, may reduce risk of stroke in women. This trial was registered at clinicaltrials.gov as NCT01127698.
Omega-6 (n-6) and omega-3 (n-3) polyunsaturated fatty acids (PUFA) are precursors of potent lipid mediators, termed eicosanoids, which play an important role in the regulation of inflammation. Eicosanoids derived from n-6 PUFAs (e.g., arachidonic acid) have proinflammatory and immunoactive functions, whereas eicosanoids derived from n-3 PUFAs [e.g., eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)] have anti-inflammatory properties, traditionally attributed to their ability to inhibit the formation of n-6 PUFA-derived eicosanoids. While the typical Western diet has a much greater ratio of n-6 PUFAs compared with n-3 PUFAs, research has shown that by increasing the ratio of n-3 to n-6 fatty acids in the diet, and consequently favoring the production of EPA in the body, or by increasing the dietary intake of EPA and DHA through consumption of fatty fish or fish-oil supplements, reductions may be achieved in the incidence of many chronic diseases that involve inflammatory processes; most notably, these include cardiovascular diseases, inflammatory bowel disease (IBD), cancer, and rheumatoid arthritis, but psychiatric and neurodegenerative illnesses are other examples.