Wellness Database: Depression
Poor dietary habits can contribue to depression, and certain supplements may be able to help with this condition. Chronic diseases such as diabetes and obesity can contribute to depression, which often in-turn leads to decisions by the individual which worsen the chronic disease, such as overeating regularly as a coping mechanism.
Vitamin D Supplementation Relieves Depression in Adolescents
Summary: In this study, vitamin D supplementation was found to improve symptoms of depression in adolescent subjects with vitamin D deficiency. Subjects (n=54) were depressed adolescents and/ vitamin D deficient (n=48). Well-being and symptoms related to depression and vitamin D status were evaluated with WHO-5 well-being scale, The Mood and Feelings Questionnaire (MFQ-S), and a vitamin D deficiency scale. Results of vitamin D supplementation included increased well-being, improvements in depressed feelings, irritability, tiredness, mood swings, sleep difficulties, weakness, concentration and pain. Findings suggest supplementation of vitamin D may be useful in ameliorating of symptoms of depression in adolescents.
Omega-3 Fatty Acids Associated with Higher Cognitive Function in Previously Depressed
Summary: Associations between omega-3 PUFA concentrations and cognitive function in an at-risk sample of older people with previous major depression were examined in this cross-sectional study. Participants (n=132) (mean +/- SD age: 67.8 +/- 6.6 y) had recovered from major depression. Samples and information were taken through questionnaire, cognitive tests and fasting blood samples. Higher EPA and total omega-3 PUFA concentrations and a lower ratio of arachidonic acid to EPA in erythrocyte membranes were associated with a higher cognitive composite score, adjusted for education levels. The strongest and most consistent correlations were found between immediate recall and concentrations of total omega-3 PUFAs and alpha-linolenic acid (ALA) in erythrocytes, which were observed only in participants with recurrent depression. Findings suggest that total erythrocyte omega-3 PUFA concentrations may be positively associated with cognitive function, immediate recall, in elderly population with previous depression and that lower concentrations of omega-3 PUFAs or ALA in erythrocyte membranes may be good predictors for cognitive impairment in the same population.
Nutritional Imbalance Observed in Adults with Mood Disorders
Summary: Study authors found an inverse relationship between nutritional intake and mood disorders in this cross-sectional survey. Subjects were adults (n=97) with bipolar or major depressive disorder, on average, 46 (+/-13) years of age (69 women, 28 men, 60 with a university degree, 39 low income). Food records over a 3 day period compared nutrient intakes with reference standards. Blood levels, bivariate and multivariate analyses of sociodemographic and clinical variables on nutrient intakes were all assessed. Compared with the reference standard, a larger proportion of the sample was below the estimated average requirement for thiamin, riboflavin, folate, phosphorous, zinc, vitamin B(6) and vitamin B(12). Income, relationship status, age, gender, and caloric intake were associated as outcome variables. Lower intakes of thiamin and phosphorous were found with antidepressant use; higher calcium and iron intakes were associated with anti-anxiety medication use; magnesium intakes were increased with mood stabilizers. Researchers concluded that adults with mood disorders are at risk for nutritional imbalance and that social, demographic, and clinical factors may affect nutrient intakes.
Omega 3 Fatty Acids May Reduce Suicide Risks
Summary: In a retrospective, case-control study involving 1,600 subjects (800 U.S. military suicide deaths and 800 controls), risk of suicide death was 14% higher per standard deviation of lower DHA percentage (OR=1.14), according to adjusted logistic regression analysis. In men, the risk of suicide death was 62% greater with lower serum DHA status (adjusted OR=1.62). The authors state, "This US military population had a very low and narrow range of n-3 HUFA status. Although these data suggest that low serum DHA may be a risk factor for suicide, well-designed intervention trials are needed to evaluate causality."
Zinc May Reduce Depression
Summary: In this review, the authors examined results from all published, randomized, controlled trials investigating the efficacy of zinc supplementation in reducing or preventing depressive symptoms, and after reviewing results from 4 studies that met their inclusion criteria, the authors found that as an adjunct to anti-depressant drug treatment, zinc supplementation was found to significantly reduce depressive symptom scores. Less clear, but evidence also points to the benefits of zinc as a stand-alone intervention. The authors state, "However, there are methodological limitations in existing studies and so further well-designed, adequately powered research is required."
Reference: "The efficacy of zinc supplementation in depression: Systematic review of randomised controlled trials," Lai J, Moxey A, et al, J Affect Disord, 2011 July 26; [Epub ahead of print]. (Address: Centre of Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, New South Wales, Australia).
EPA May Help Treat Depression
Summary: Eicosapentaenoic acid (EPA) may be the effective component in omega-3 polyunsaturated fatty acid (PUFA) treatment for depression. In this review, PubMed/MeSH was searched for studies published in English from 1960 through June 2010. The search was supplemented by manual bibliography review and examination of relevant review articles. Researchers included studies (n= 15 trials, 916 subjects) which were prospective, randomized, double-blinded, and placebo-controlled, where depression was the primary complaint and PUFA was administered, and where appropriate outcome measures were used to assess depressed mood. Percentage of EPA in the supplements was the fixed-effect predictor, dichotomized into 2 groups: EPA < 60% or EPA >= 60% of the total EPA + DHA. Secondary analyses explored the relevance of treatment duration, age, and EPA dose. Supplements with EPA >= 60% showed benefit on standardized mean depression scores versus supplements with EPA < 60%, with negligible contribution of random effects or heteroscedasticity and with no effects of treatment duration or age. Supplements with EPA < 60% were ineffective. Exploratory analyses showed improvement determined by the dose of EPA in excess of DHA, within the range of 200 to 2,200 mg/d of EPA.
Omega 3 Fatty Acids May Help Treat Bipolar Depression
In this meta-analysis, researchers found that omega-3 supplementation may help promote relief from bipolar depression, while no such effect was found for attenuating mania in patients with bipolar disorder. Findings were taken from clinical trials over several databases, including randomized controlled studies 4 weeks or longer with a sample size > 10, conducted in English, with no age, gender or ethnic criteria using search terms "bipolar disorder OR bipolar depression OR bipolar mania OR mania OR hypomania OR cyclothymia with the search terms omega 3 OR essential fatty acids OR polyunsaturated fatty acids OR DHA OR EPA OR fish oil OR flax oil". Data was extracted using a random-effects model. The synthesis of the data revealed a significant effect in favor of omega-3 for bipolar depression, but insignificant in relation to bipolar mania. Researchers also found that study sample sizes influenced the findings with smaller sample sizes providing larger effect sizes. The results suggest a strong basis for adjunctive use of omega-3 fatty acids in treating bipolar depression.
Omega 3 and Omega 6 Fatty Acids May Be Beneficial for Depression
Summary: In a prospective study involving 54,632 women between 50 and 77 years of age, free from depressive symptoms at baseline, followed up with for an average of 10 years, during which time 2,823 incident cases of depression were documented, intake of alpha linolenic acid (ALA) was found to be inversely associated with depressive risk (multivariate RR for 0.5 g/d increment=0.82), with a stronger association found in women with low linoleic acid intake. Intake of long-chain omega-3 fatty acids from fish was not found to be associated with depressive symptoms. The authors state, "...these data support the hypothesis that higher ALA and lower LA intakes reduce depression risk, this relation warrants further investigation."
Reference: "Dietary intake of n-3 and n-6 fatty acids and the risk of clinical depression in women: a 10-y prospective follow-up study," Lucas M, Mirzaei F, et al, Am J Clin Nutr, 2011 June; 93(6): 1337-43. (Address: Departments of Nutrition and Society, Human Development, and Health, Harvard School of Public Health, Boston, MA, USA).
Vitamin D May Help Prevent Depression
Summary: In a cross sectional study and prospective analysis of vitamin D intake from foods and supplements and risk of depressive symptoms, data from 81,189 women (aged 50-79 years at baseline) was analyzed and it was found that vitamin D intake (800 IU/d or greater) was associated with a reduced prevalence of depressive symptoms (OR=0.79), as compared to women consuming less than 100 IU/d. A 20% lower risk of depressive symptoms was found in women (without depressive symptoms at baseline) consuming at least 400 IU/d vitamin D from food sources, as compared to less than 100 IU/d, after 3 years (OR=0.80). The authors conclude, "Overall, our findings support a potential inverse association of vitamin D, primarily from food sources, and depressive symptoms in postmenopausal women. Additional prospective studies and randomized trials are essential in establishing whether the improvement of vitamin D status holds promise for the prevention of depression, the treatment of depression, or both."
Reference: "Vitamin D intake from foods and supplements and depressive symptoms in a diverse population of older women," Bertone-Johnson ER, Powers SI, et al, Am J Clin Nutr, 2011 Aug 24; [Epub ahead of print]. (Address: University of Massachusetts, Amherst, MA, USA).
Omega 3 Fatty Acids Reduce Depression
Omega-3 fatty acids play a critical role in the development and function of the central nervous system. Emerging research is establishing an association between omega-3 fatty acids (alpha-linolenic, eicosapentaenoic, docosahexaenoic) and major depressive disorder. Evidence from epidemiological, laboratory and clinical studies suggest that dietary lipids and other associated nutritional factors may influence vulnerability and outcome in depressive disorders.
The author's conclude: [G]iven the current excess intake of omega-6 rich oils, and the emerging research on omega-3 fatty acids and MDD, all mental health professionals should at least ensure adequate intake of omega-3 fatty acids among patients with MDD. The current average North American intake of EPA and DHA is approximately 130 mg per day, well short of the minimum 650 mg recommended by the international panel of lipid experts. While it is not necessary for mental health professionals to become clinical nutritionists, consideration of a patient's dietary quality may be worthwhile. Hopefully future research will determine if dietary modifications or supplementation can influence the outcome of standard care.
Omega-3 fatty acids and major depression: A primer for the mental health professional. Lipids Health Dis. 2004; 3: 25. Published online 2004 November 9. doi: 10.1186/1476-511X-3-25
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