Natural Mood Boosters

May 19, 2010 Written by JP    [Font too small?]

According to the National Institute of Mental Health almost 10% of the US adult population is living with a mood disorder. Approximately 15,000 million of these men and women carry the diagnosis of major depressive disorder. An additional 3 million adults are dealing with a milder form of chronic depression referred to as dysthymic disorder. (1)

There’s no shortage of conventional treatments for nearly all forms of depression. Medications such as Celexa, Effexor, Paxil and Zoloft are so commonly advertised and prescribed that even non-depressed individuals often recognize their names. However, there’s a sizable population of depressed patients that prefers to approach mood disorders without the use of prescription drugs.

Three new studies offer support for these patients and their physicians if they choose to opt for a non-pharmacological option. To be clear, these therapies may not be suitable for all patients and are not intended to replace a consultation with an appropriate mental health practitioner.

A trial presented in the May 11th issue of the journal Psychiatry Research evaluated the relative effects of three therapeutic approaches to depression: a) purified fish oil yielding 1,000 of EPA (eicosapentaenoic acid); b) 20 mg of the antidepressant medication fluoxetine (Prozac); c) a combination of EPA + Prozac. Over the course of 8 weeks, 42 patients with major depressive disorder (MDD) were divided into three groups and provided with the respective interventions. The primary discovery of the research was that all of the study volunteers demonstrated a statistically significant reduction in cortisol (a stress hormone) levels. Given that the fish oil was equally effective as the prescription medication, this may allow for a safer alternative. (2)

Measuring Vitamin D levels may one day become a standard test used by psychiatrists working with depressed patients. A recent Italian study looked at Vitamin D concentrations in a group of nearly 1,000 senior men and women over a 6-year period of time. The researchers noted the following clinically relevant observations:

  • Women with D levels below 50 nmol/l were significantly more prone to depression at a 3 and 6 year follow up exam.
  • Non-depressed women exhibited a “higher risk of developing depressive mood” if they had low Vitamin D levels.
  • “Men with low Vit-D tended to have a higher risk of developing depressed mood” as well.

The authors of the population study concluded that “hypovitaminosis D is a risk factor for the development of depressive symptoms in older patients”. They went on to report that the “strength of the prospective association is higher in women than in men”. (3)

Low Vitamin D Levels = Higher Depression Rates in Older Men & Women
Source: Arch Gen Psychiatry. 2008;65(5):508-512. (link)

The final holistic approach of the day falls under the category of a mind-body exercise. Scientists from Taipei Medical University enrolled 62 coronary heart disease (CHD) patients in a controlled, randomized study which compared the mood elevating effects of deep breathing exercises vs. “weekly telephone support”. Over the course of 2 weeks, 28 depressed CHD patients practiced “home-based deep-breathing” exercises while 34 patients received conventional support via telephone consultations provided by nurses. Those engaging in the breathing intervention demonstrated significantly greater reductions in depressive symptoms as assessed by their scores on two popular indices – the Beck Depression Inventory-II (BDI-II) and the Patient Health Questionnaire-9 (PHQ-9). In all, the number of severely depressed patients in the deep-breathing group dropped by over half, from 28.6% pre-test to 10.7% post-test. (4)

Some patients hesitate to discuss alternative and complementary therapies with their allopathic/conventional physicians. This is an unhealthy trend that harms all parties involved. In the field of medicine, patients are the consumers. There should be a certain expectation that their concerns and points of view will be treated respectfully and dealt with thoughtfully. One of the best ways to accomplish this is to present scientifically-based information to physicians. This “speaks” to them because science is their language. If you couple that with a kind, non-threatening demeanor, you might be surprised at how accommodating and responsive your health care team may be.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!


Tags: , ,
Posted in Alternative Therapies, Mental Health, Nutritional Supplements

27 Comments & Updates to “Natural Mood Boosters”

  1. Low Carb Daily ~ Angie Says:

    In the past, I have kind of been afraid to mention any kind of alternative method for healing to my primary care physician, but you make really good points about why I should.

    I think it’s great that I have one who takes time with me and seems to genuinely care about my well-being more than the clock on the wall.

    Great article, as always, JP. I think there used to be such a stigma about depression and other mental health issues, but it makes so much sense if you think about the body as a whole.. which I know you do…


  2. JP Says:

    Thank you, Angie! You have officially made my day! 🙂

    Be well!


  3. Nina K. Says:

    Hi JP ☼

    my best natural mood booster is “” 🙂 😉

    Another way for me is – i mentioned it earlier – Matchatea (L-Theanin) and im eating lots of hering, salmon and shrimps. During this long long dark and cold winter this helped me a lot against my yearly winter depression 🙂

    Nina K.

  4. JP Says:

    Thanks, Nina! You’re too kind! 🙂

    Your dietary strategy is both intuitive and backed by good science! A great combination!

    Be well!


  5. JP Says:

    Update 05/13/15:

    Appetite. 2015 May 8. pii: S0195-6663(15)00228-7.

    Habitual total water intake and dimensions of mood in healthy young women.

    Acute negative and positive mood states have been linked with the development of undesirable and desirable health outcomes, respectively. Numerous factors acutely influence mood state including exercise, caffeine ingestion, and macronutrient intake, but the influence of habitual total water intake remains unknown. The purpose of this study was to observe relationships between habitual water intake and mood. 120 healthy females (mean±SD; age=20±2 y, BMI=22.9±3.5 kg⋅m-2 ) recorded all food and liquids consumed for 5 consecutive days. Investigators utilized dietary analysis software to determine Total Water Intake (TWI; total water content in foods and fluids, coffee ingestion, and macronutrient consumption (i.e. protein, carbohydrate, fat)). On days 3 and 4, participants completed the Profile of Mood State (POMS) questionnaire which examined tension, depression, anger, vigor, and confusion, plus an aggregate measure of Total Mood Disturbance (TMD). For comparison of mood, data were separated into three even groups (n=40 each) based on TWI: low (LOW; 1.51±0.27 L/d), moderate (MOD; 2.25±0.19 L/d), and high (HIGH; 3.13±0.54 L/d). Regression analysis was performed to determine continuous relationships between measured variables. Group differences (p<0.05) were observed for tension (MOD=7.2±5.4, HIGH=4.4±2.9), depression (LOW=4.5±5.9, HIGH=1.7±2.3), confusion (MOD=5.9±3.4, HIGH=4.0±2.1), and TMD (LOW=19.0±21.8, HIGH=8.2±14.2). After accounting for other mood influencers, TWI predicted TMD (r2 = 0.140; p=0.050). The above relationships suggest the amount of water a woman consumes is associated with mood state.

    Be well!


  6. JP Says:

    Update 05/18/15:

    Nutritional Neuroscience – Volume 18, Issue 4

    Objective: Previous studies have shown a positive effect of zinc as an adjunctive therapy on reducing depressive symptoms. However, to our knowledge, no study has examined the effect of zinc monotherapy on mood. The aim of the present study was to determine the effects of zinc monotherapy on depressive symptoms and serum brain-derived neurotrophic factor (BDNF) levels in overweight or obese subjects.

    Methods: Fifty overweight or obese subjects were randomly assigned into two groups and received either 30 mg zinc or placebo daily for 12 weeks. At baseline and post-intervention, depression severity was assessed using Beck depression inventory II (BDI II), and serum BDNF and zinc levels were determined by enzyme-linked immunosorbent assay and atomic absorption spectrophotometry, respectively.

    Results: The trial was completed with 46 subjects. After a 12-week supplementation, serum zinc and BDNF levels increased significantly in the zinc-supplemented group compared with the placebo group. BDI scores declined in both the groups at the end of the study, but reduction in the zinc-supplemented group was significantly higher than the placebo group. More analysis revealed that following supplementation, BDI scores decreased in subgroup of subjects with depressive symptoms (BDI ≥ 10) (n = 30), but did not change in the subgroup of non-depressed subjects (BDI < 10) (n = 16). Moreover, a significant inverse correlation was observed between serum BDNF levels and depression severity in all participants. Interestingly, a significant positive correlation was found between serum BDNF and zinc levels at baseline. Conclusion: Zinc monotherapy improves mood in overweight or obese subjects most likely through increasing BDNF levels. Be well! JP

  7. JP Says:

    Updated 11/10/15:

    J Evid Based Complementary Altern Med. 2015 Nov 5.

    Omega-3 Fatty Acids and Cholesterol Have a Main Role in Antidepression Diet of Iranian Traditional Medicine.

    Depression is one of the major health problems of our world. Recent studies have revealed the relationship between diet and depression. In Iranian traditional medicine, there is a therapeutic diet that is recommended in melancholic diseases like depression. One of the main components of this diet is meat. Meats are divided into 2 groups: recommended and abstinent. The aim of this study was to clarify the logic of this diet through comparing nutritional elements of the 2 groups with each other. For this purpose, prominent books on Iranian traditional medicine were searched for abstinent and recommended meats traditionally prescribed for depressed patients. The results of each group were compared with the other by using Mann-Whitney Test (SPSS version 16). The results showed that recommended meats contain higher amounts of polyunsaturated fatty acids (P = .01) especially omega-3 (P = .03). Both groups contain high amounts of cholesterol. Iranian traditional medicine recommends consumption of meats that contains cholesterol with omega-3 fatty acids in depression.

    Be well!


  8. JP Says:

    Updated 11/30/15:

    Phytother Res. 2015 Nov 27.

    The Role of Curcumin Administration in Patients with Major Depressive Disorder: Mini Meta-Analysis of Clinical Trials.

    Major depression is a common, recurrent, and chronic disease that negatively affects the quality of life and increases the risk of mortality. Several studies have demonstrated that curcumin, the yellow-pigmented substance of the turmeric, possesses antidepressant properties. The aim of this review is to meta-analytically assess the antidepressant effect of curcumin in patients with major depressive disorders. We extensively searched the literature until August 2015. The random-effect model was used to calculate the pooled standardized difference of means (SMD). Subgroup analyses were also performed to examine the effect of different study characteristics on the overall model. Six clinical trials met the inclusion criteria. Overall, curcumin administration showed a significantly higher reduction in depression symptoms [SMD = -0.34; 95% confidence interval (CI) = -0.56, -0.13; p = 0.002]. Subgroup analyses showed that curcumin had the highest effect when given to middle-aged patients (SMD = -0.36; 95% CI = -0.59; -0.13; p = 0.002), for longer duration of administration (SMD = -0.40; 95% CI = -0.64, -0.16; p = 0.001), and at higher doses (SMD = -0.36; 95% CI = -0.59, -0.13; p = 0.002). The administration of new formulation of curcumin (BCM-95) had non-significantly higher effect on depression as compared with the conventional curcumin-piperine formula. We conclude that there is supporting evidence that curcumin administration reduces depressive symptoms in patients with major depression.

    Be well!


  9. JP Says:

    Updated 12/30/15:

    Nutrition. 2015 Sep 28.

    Clinical and metabolic response to probiotic administration in
    patients with major depressive disorder: A randomized, double-blind,
    placebo-controlled trial.

    OBJECTIVE: We are aware of no study examining the effects of probiotic
    supplementation on symptoms of depression, metabolic profiles, serum
    high-sensitivity C-reactive protein (hs-CRP), and biomarkers of
    oxidative stress in patients with major depressive disorder (MDD). The
    present study was designed to determine the effects of probiotic
    intake on symptoms of depression and metabolic status in patients with

    METHODS: This randomized, double-blind, placebo-controlled clinical
    trial included 40 patients with a diagnosis of MDD based on DSM-IV
    criteria whose age ranged between 20 and 55 y. Patients were randomly
    allocated into two groups to receive either probiotic supplements (n =
    20) or placebo (n = 20) for 8 wk. Probiotic capsule consisted of three
    viable and freeze-dried strains: Lactobacillus acidophilus (2 × 109
    CFU/g), Lactobacillus casei (2 × 109 CFU/g), and Bifidobacterium
    bifidum (2 × 109 CFU/g). Fasting blood samples were taken at the
    beginning and end of the trial to quantify the relevant variables. All
    participants provided three dietary records (two weekdays and one
    weekend) and three physical activity records during the intervention.

    RESULTS: Dietary intake of study participants was not significantly
    different between the two groups. After 8 wk of intervention, patients
    who received probiotic supplements had significantly decreased Beck
    Depression Inventory total scores (-5.7 ± 6.4 vs. -1.5 ± 4.8, P =
    0.001) compared with the placebo. In addition, significant decreases
    in serum insulin levels (-2.3 ± 4.1 vs. 2.6 ± 9.3 μIU/mL, P = 0.03),
    homeostasis model assessment of insulin resistance (-0.6 ± 1.2 vs. 0.6
    ± 2.1, P = 0.03), and serum hs-CRP concentrations (-1138.7 ± 2274.9
    vs. 188.4 ± 1455.5 ng/mL, P = 0.03) were observed after the probiotic
    supplementation compared with the placebo. Additionally, taking
    probiotics resulted in a significant rise in plasma total glutathione
    levels (1.8 ± 83.1 vs. -106.8 ± 190.7 μmol/L, P = 0.02) compared with
    the placebo. We did not find any significant change in fasting plasma
    glucose, homeostatic model assessment of beta cell function,
    quantitative insulin sensitivity check index, lipid profiles, and
    total antioxidant capacity levels.

    CONCLUSIONS: Probiotic administration in patients with MDD for 8 wk
    had beneficial effects on Beck Depression Inventory, insulin,
    homeostasis model assessment of insulin resistance, hs-CRP
    concentrations, and glutathione concentrations, but did not influence
    fasting plasma glucose, homeostatic model assessment of beta cell
    function, quantitative insulin sensitivity check index, lipid
    profiles, and total antioxidant capacity levels.

    Be well!


  10. JP Says:

    Updated 04/23/16:

    Biopsychosoc Med. 2016 Apr 21;10:11.

    Aromatic effects of a Japanese citrus fruit-yuzu (Citrus junos Sieb. ex Tanaka)-on psychoemotional states and autonomic nervous system activity during the menstrual cycle: a single-blind randomized controlled crossover study.

    BACKGROUND: Yuzu (Citrus junos Sieb. ex Tanaka), a yellow-golden colored citrus fruit, has traditionally been used to promote psychosomatic health in Japan. While the yuzu produces a distinctive, pleasing aroma of citrus and floral, the efficacy of its fragrance remains unknown. The present study investigated the soothing effects of the fragrance of yuzu essential oil from the perspective of autonomic nervous system activity, which plays a crucial role in the integrity of the mind-body connection.

    METHODS: Twenty one women in their 20s participated in a single-blind randomized controlled crossover study. Subjects were examined twice each in the follicular and late-luteal phases. Two kinds of aromatic stimulation (yuzu and water as a control) were used. This experiment measured heart rate variability (HRV) reflecting autonomic nervous system activity and used the Profile of Mood States (POMS) as a psychological index before and after the aromatic stimulation.

    RESULTS: Only a 10-min inhalation of the yuzu scent significantly decreased heart rate and increased high frequency power of HRV reflecting parasympathetic nervous system activity, regardless of menstrual phase. This significant physiological effect continued for at least 25 min. In addition, the POMS tests revealed that inhalation of the aromatic yuzu oil significantly decreased total mood disturbance, a global measure of affective state, together with two POMS subscales-tension-anxiety and fatigue, as long as 35 min after the aroma stimulation, both in the symptomatic late-luteal and non-symptomatic follicular phases.

    CONCLUSIONS: The present study provides the novel information that yuzu’s aromatic effects could serve to alleviate negative emotional stress, which, at least in part, would contribute to the improvement of parasympathetic nervous system activity.

    Be well!


  11. JP Says:

    Updated 06/28/16:

    Nutrition Research Published Online: June 21, 2016

    Probiotic supplementation can positively affect anxiety and depressive symptoms: a systematic review of randomized controlled trials

    Gastrointestinal microbiota, consisting of microbial communities in the gastrointestinal tract, play an important role in digestive, metabolic, and immune functioning. Preclinical studies on rodents have linked behavioral and neurochemical changes in the central nervous system with deficits or alterations in these bacterial communities. Moreover, probiotic supplementation in rodents has been shown to markedly change behavior, with correlated changes in central neurochemistry. While such studies have documented behavioral and mood-related supplementation effects, the significance of these effects in humans, especially in relation to anxiety and depression symptoms are relatively unknown. Thus, the purpose of this paper was to systematically evaluate current literature on the impact of probiotic supplementation on anxiety and depression symptoms in humans. To this end, multiple databases, including Medline, PsycINFO, PubMed, Scopus, and Web of Science were searched for randomized controlled trials (RCTs) published between January 1990 and January 2016. Search results led to a total of 10 RCTs (4 in clinically diagnosed and 6 in non-clinical samples) that provided limited support for the use of some probiotics in reducing human anxiety and depression. Despite methodological limitations of the included trials and the complex nature of gut-brain interactions, results suggest the detection of apparent psychological benefits from probiotic supplementation. Nevertheless a better understanding of developmental, modulatory, and metagenomic influences on the GI mictobiota, specifically as they relate to mood and mental health, represent strong priorities for future research in this area.

    Be well!


  12. JP Says:

    Updated 08/15/16:

    Nutrients. 2016 Aug 6;8(8).

    Effect of Probiotics on Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    It has been reported that gut probiotics play a major role in the bidirectional communication between the gut and the brain. Probiotics may be essential to people with depression, which remains a global health challenge, as depression is a metabolic brain disorder. However, the efficacy of probiotics for depression is controversial. This study aimed to systematically review the existing evidence on the effect of probiotics-based interventions on depression. Randomized, controlled trials, identified through screening multiple databases and grey literature, were included in the meta-analysis. The meta-analysis was performed using Review Manager 5.3 software using a fixed-effects model. The meta-analysis showed that probiotics significantly decreased the depression scale score (MD (depressive disorder) = -0.30, 95% CI (-0.51–0.09), p = 0.005) in the subjects. Probiotics had an effect on both the healthy population (MD = -0.25, 95% CI (-0.47–0.03), p = 0.03) and patients with major depressive disorder (MDD) (MD = -0.73, 95% CI (-1.37–0.09), p = 0.03). Probiotics had an effect on the population aged under 60 (MD = -0.43, 95% CI (-0.72–0.13), p = 0.005), while it had no effect on people aged over 65 (MD = -0.18, 95% CI (-0.47-0.11), p = 0.22). This is the first systematic review and meta-analysis with the goal of determining the effect of probiotics on depression. We found that probiotics were associated with a significant reduction in depression, underscoring the need for additional research on this potential preventive strategy for depression.

    Be well!


  13. JP Says:

    Updated 08/29/16:

    J Am Psychiatr Nurses Assoc. 2016 Aug 26.

    A Randomized Controlled Trial of Mindfulness Versus Yoga: Effects on Depression and/or Anxiety in College Students.

    BACKGROUND: Depression and anxiety disorders are two of the most common mental disorders in the United States. These disorders are prevalent among college students.

    OBJECTIVE: The main objective of this study is to compare the effectiveness of two different types of intervention practices (mindfulness vs. yoga) and a noninterventional control group in mitigating the effects of depression and/or anxiety in college students.

    METHOD: A sample of 90 students (both genders) over age 18 who had a diagnosis of anxiety and/or depression was recruited from 11,500 undergraduate college students in a mid-size university. The study’s design included stratified-randomized controlled repeated measures with three groups: a mindfulness intervention group, a yoga-only intervention group, and a noninterventional group. Participants were randomly assigned to the aforementioned three groups. Participants in the intervention groups received an 8-week training either in mindfulness or yoga. Depressive, anxiety, stress symptoms, self-compassion, and mindfulness were measured at baseline, Week 4, Week 8, and Week 12.

    RESULTS: Depressive, anxiety, and stress symptoms decreased significantly (p < .01) from baseline to follow-up conditions in both the mindfulness and yoga intervention groups. The changes in mindfulness scores were also significant in both groups. However, the changes in self-compassion scores were significant only in the mindfulness intervention group. No significant changes in the control group were demonstrated. CONCLUSIONS: The findings from this study can provide useful information to nurses and other health care providers. This study may have implications for a cost-effective treatment for depression and anxiety. Be well! JP

  14. JP Says:

    Updated 10/27/16:

    Nutrients 2016, 8(11), 668; doi:10.3390/nu8110668

    Effects of Walnut Consumption on Mood in Young Adults—A Randomized Controlled Trial

    Walnuts contain a number of potentially neuroprotective compounds like vitamin E, folate, melatonin, several antioxidative polyphenols and significant amounts of ω-3 fatty acids. The present study sought to determine the effect of walnuts on mood in healthy volunteers. Sixty-four college students were randomly assigned to two treatment sequences in a crossover fashion: walnut–placebo or placebo–walnut. At baseline mood was assessed using Profiles of Mood States (POMS). Data was collected again after eight weeks of intervention. After six-weeks of washout, the intervention groups followed the diets in reverse order. Data was collected once more at the end of the eight-week intervention period. No significant changes in mood were observed in the analyses with both genders combined and in females. However, we have observed a significant medium effect size improvement in the Total Mood Disturbance score (−27.49%, p = 0.043, Cohen’s d = 0.708) in males. In non-depressed healthy young males, walnuts seem to have the ability to improve mood.

    Be well!


  15. JP Says:

    Updated 11/08/16:

    J Affect Disord. 2016 Oct 26.

    Association between low serum 25-hydroxyvitamin D and depression in a large sample of Chinese patients with type 2 diabetes mellitus.

    BACKGROUND: Because of the absence of data on the direct association between vitamin D and depression in patients with diabetes, we examined the association between vitamin D state (assessed by 25-hydroxyvitamin D [25(OH)D]) and the prevalence of depression in adult patients with type 2 diabetes mellitus(T2DM).

    METHOD: Cross-sectional data were obtained from 2786 patients with T2DM recruited from a Chinese diabetes registry. Patients’ records were reviewed to obtain data pertaining to age, sex, Body Mass Index (BMI), marital status, level of education, smoking status, duration of diabetes mellitus, use of insulin, and presence of additional illnesses. A multiple logistic regression analysis adjusted for potential confounders was used to assess independent associations between serum levels of 25 (OH)D and depression (defined by the Patient Health Questionnaire-9).

    RESULTS: Using the PHQ-9 cutoff value of ≥10, 5.71% (159/2786; 95% CI: 4.85-6.57%) were considered to have depression. The serum 25(OH)D levels were significantly lower in diabetic patients with depression than those patients without depression [10.2(IQR, 7.6-15.2)ng/ml vs. 14.6(IQR, 10.7-19.8)ng/ml, respectively; P<0.0001]. Multivariate logistic regression analysis considering traditional risk factors and other biomarkers showed an inverse relationship between serum 25 (OH)D levels and depression when serum 25 (OH)D were used as a continuous variable (OR, 0.84; 95% CI, 0.77-0.90; P<0.001). Compared with the first quartile of serum 25 (OH)D levels, the second quartile OR for depression was 0.83 (95% CI, 0.75-0.92, P=0.012). For the third and fourth quartiles, it was 0.40 (95% CI, 0.33-0.52, P<0.001) and 0.15 (95% CI, 0.08-0.22; P<0.001), respectively.

    CONCLUSIONS: We observed a significant negative association between serum levels of 25 (OH)D and depression in Chinese patients with T2DM.

    Be well!


  16. JP Says:

    Updated 11/03/16:

    BMJ Open Sport Exerc Med. 2015 Nov 2;1(1):e000036.

    Exercise as medicine-the use of group medical visits to promote physical activity and treat chronic moderate depression: a preliminary 14-week pre-post study.

    OBJECTIVE: The evidence that regular physical activity can treat depressive disorders is increasingly robust. However, motivating patients with depression to engage in physical activity can be challenging. Interdisciplinary group medical visits (GMVs) with an integrated physical activity component may be a novel means to support patients in becoming more active.

    METHODS: We conducted a ‘pre-post’ pilot study within a primary care setting. Participants were adults (≥18 years) with a chronic major depressive disorder or a bipolar 2 disorder (depression; chronic). A psychiatrist and exercise therapist co-led a series of 14 weekly 2 h GMVs. Each group visit combined specific medical advice, physical activity, patient discussions and a targeted educational component. Participants also attended 11 weekly hatha yoga classes. Primary outcome was ‘steps’ as measured by accelerometer (SenseWear) as well as depression (Patient Health Questionnaire, PHQ-9) and anxiety (Generalised Anxiety Disorder, GAD-7) ratings.

    RESULTS: 14 of 15 participants (93.3%) completed the 14-week programme. After 3 months postintervention, median depression scales (PHQ-9) decreased 38% from 16 to 10 (p<0.01; IQR pre/post 8/12); and median anxiety scales (GAD-7) decreased 50% from 13 to 6.5 (p<0.05; IQR 8.5/9). Median daily 'steps' increased 71% from 3366 to 5746 (IQR 2610/6237), though this was not significant (p>0.10).

    CONCLUSIONS: While other studies have examined the efficacy of GMVs in addressing chronic illnesses and the promotion of lifestyle changes, none to our knowledge have embedded physical activity within the actual patient visits. Interdisciplinary GMVs (eg, psychiatrist/exercise professional) may be a means to decrease depression and anxiety ratings within clinical care while improving physical activity.

    Be well!


  17. JP Says:

    Updated 01/17/17:

    BMC Psychiatry. 2017 Jan 14;17(1):15.

    Association between depression and fruit and vegetable consumption among adults in South Asia.

    BACKGROUND: In recent years there has been a growing research interest regarding the impact of dietary behaviour on mental health outcomes. The present study aimed to investigate the association between fruit and vegetable (F&V) consumption and depression in three south Asian countries- Bangladesh, India and Nepal.

    METHODS: Cross-sectional data were obtained from World Health Survey of WHO conducted during 2002-04. In total 14,133 adult subjects (Bangladesh 3262, India 7594, Nepal 3277) aged 18 years and above were included in the study. Outcome variables were Self-Reported Depression (SRD) during last 30 days and 12 months. Multivariable regression methods were used to explore the association between F&V consumption and depression.

    RESULTS: Prevalence of Self-Reported Depression during past 12 months were respectively 39%, 17.7%, and 49.9% for Bangladesh, India and Nepal. In India, those who consumed less than five servings of vegetables were respectively 41% [AOR = 1.41; 95%CI = 0.60-3.33] and 57% [AOR = 1.57; 95%CI = 0.93-2.64] more likely to report severe-extreme and mild-moderate depression during past 30 days compared to those who consumed five servings a day. Regarding fruit consumption, compared to those who consumed five servings a day, the odds of severe-extreme and mild-moderate SRD were respectively 3.5 times [AOR = 3.48; 95%CI = 1.216-10.01] and 45% [AOR = 1.44; 95%CI = 0.89-2.32] higher in Bangladesh, and 2.9 times [AOR = 2.92; 95%CI = 1.12-7.64] and 42% higher [AOR = 1.41; 95%CI = 0.89-2.24] in Nepal compared to those who consumed less than five servings a day during last 30 days.

    CONCLUSION: Daily intake of less than five servings of F&V was associated with higher odds of depression. Nutrition programs aimed at promoting F&V consumption might prove beneficial to reduce the prevalence of depression in south Asian population. Further studies are required to understand the factors limiting the adequate consumption of F&V.

    Be well!


  18. JP Says:

    Updated 02/02/17:

    BMC Med. 2017 Jan 30;15(1):23.

    A randomised controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial).

    BACKGROUND: The possible therapeutic impact of dietary changes on existing mental illness is largely unknown. Using a randomised controlled trial design, we aimed to investigate the efficacy of a dietary improvement program for the treatment of major depressive episodes.

    METHODS:’SMILES’ was a 12-week, parallel-group, single blind, randomised controlled trial of an adjunctive dietary intervention in the treatment of moderate to severe depression. The intervention consisted of seven individual nutritional consulting sessions delivered by a clinical dietician. The control condition comprised a social support protocol to the same visit schedule and length. Depression symptomatology was the primary endpoint, assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS) at 12 weeks. Secondary outcomes included remission and change of symptoms, mood and anxiety. Analyses utilised a likelihood-based mixed-effects model repeated measures (MMRM) approach. The robustness of estimates was investigated through sensitivity analyses.

    RESULTS: We assessed 166 individuals for eligibility, of whom 67 were enrolled (diet intervention, n = 33; control, n = 34). Of these, 55 were utilising some form of therapy: 21 were using psychotherapy and pharmacotherapy combined; 9 were using exclusively psychotherapy; and 25 were using only pharmacotherapy. There were 31 in the diet support group and 25 in the social support control group who had complete data at 12 weeks. The dietary support group demonstrated significantly greater improvement between baseline and 12 weeks on the MADRS than the social support control group, t(60.7) = 4.38, p < 0.001, Cohen's d = -1.16. Remission, defined as a MADRS score <10, was achieved for 32.3% (n = 10) and 8.0% (n = 2) of the intervention and control groups, respectively (χ 2 (1) = 4.84, p = 0.028); number needed to treat (NNT) based on remission scores was 4.1 (95% CI of NNT 2.3-27.8). A sensitivity analysis, testing departures from the missing at random (MAR) assumption for dropouts, indicated that the impact of the intervention was robust to violations of MAR assumptions.

    CONCLUSIONS: These results indicate that dietary improvement may provide an efficacious and accessible treatment strategy for the management of this highly prevalent mental disorder, the benefits of which could extend to the management of common co-morbidities.

    Be well!


  19. JP Says:

    Updated 02/17/17:

    Nutr Neurosci. 2017 Feb 15:1-11.

    Supplementation with macular carotenoids reduces psychological stress, serum cortisol, and sub-optimal symptoms of physical and emotional health in young adults.

    PURPOSE: Oxidative stress and systemic inflammation are the root cause of several deleterious effects of chronic psychological stress. We hypothesize that the antioxidant and anti-inflammatory capabilities of the macular carotenoids (MCs) lutein, zeaxanthin, and meso-zeaxanthin could, via daily supplementation, provide a dietary means of benefit.

    METHODS: A total of 59 young healthy subjects participated in a 12-month, double-blind, placebo-controlled trial to evaluate the effects of MC supplementation on blood cortisol, psychological stress ratings, behavioural measures of mood, and symptoms of sub-optimal health. Subjects were randomly assigned to one of three groups: placebo, 13 mg, or 27 mg / day total MCs. All parameters were assessed at baseline, 6 months, and 12 months. Serum MCs were determined via HPLC, serum cortisol via ELISA, and macular pigment optical density (MPOD) via customized heterochromatic flicker photometry. Behavioural data were obtained via questionnaire.

    RESULTS: Significant baseline correlations were found between MPOD and Beck anxiety scores (r = -0.28; P = 0.032), MPOD and Brief Symptom Inventory scores (r = 0.27; P = 0.037), and serum cortisol and psychological stress scores (r = 0.46; P < 0.001). Supplementation for 6 months improved psychological stress, serum cortisol, and measures of emotional and physical health (P < 0.05 for all), versus placebo. These outcomes were either maintained or improved further at 12 months. CONCLUSIONS: Supplementation with the MCs significantly reduces stress, cortisol, and symptoms of sub-optimal emotional and physical health. Determining the basis for these effects, whether systemic or a more central (i.e. brain) is a question that warrants further study. Be well! JP

  20. JP Says:

    Updated 02/25/17:

    Nutrients 2017, 9(2), 158

    Effects of Acute Blueberry Flavonoids on Mood in Children and Young Adults

    Epidemiological evidence suggests that consumption of flavonoids (usually via fruits and vegetables) is associated with decreased risk of developing depression. One plausible explanation for this association is the well-documented beneficial effects of flavonoids on executive function (EF). Impaired EF is linked to cognitive processes (e.g., rumination) that maintain depression and low mood; therefore, improved EF may reduce depressionogenic cognitive processes and improve mood. Study 1: 21 young adults (18–21 years old) consumed a flavonoid-rich blueberry drink and a matched placebo in a counterbalanced cross-over design. Study 2: 50 children (7–10 years old) were randomly assigned to a flavonoid-rich blueberry drink or a matched placebo. In both studies, participants and researchers were blind to the experimental condition, and mood was assessed using the Positive and Negative Affect Schedule before and 2 h after consumption of the drinks. In both studies, the blueberry intervention increased positive affect (significant drink by session interaction) but had no effect on negative affect. This observed effect of flavonoids on positive affect in two independent samples is of potential practical value in improving public health. If the effect of flavonoids on positive affect is replicated, further investigation will be needed to identify the mechanisms that link flavonoid interventions with improved positive mood.

    Be well!


  21. JP Says:

    Updated 06/20/17:

    J Oleo Sci. 2017 Jun 13.

    Long-chain Polyunsaturated Fatty Acid Supplementation Improves Mood in Elderly Japanese Men.

    Although several studies have reported the effects of long-chain polyunsaturated fatty acid (LCPUFA) supplementation on the mood in healthy adults, the effects of LCPUFA on elderly individuals remain unclear. Thus, we hypothesized that LCPUFA supplementation improves mood in the elderly. To address this hypothesis, 115 elderly Japanese men aged 55-64 years were assigned and randomly allocated to the LCPUFA or placebo group. Participants received 4 weeks of supplementation with LCPUFAcontaining oil (docosahexaenoic acid (DHA) 300 mg/day, eicosapentaenoic acid (EPA) 100 mg/day, arachidonic acid (ARA) 120 mg/day) or a placebo oil. Mood was assessed using the Profile of Mood States (POMS) before and after supplementation as the secondary outcome in a previously performed randomized controlled trial on cognitive function. A total of 113 participants completed the supplementation period. One hundred participants (LCPUFA, n = 51; placebo, n = 49) who were eligible for evaluation of mood were analyzed. Increases in vigor scores on POMS, reflecting a positive mood, were significantly larger in the LCPUFA group than in the placebo group (LCPUFA, +1.8; placebo, -0.5). No significant differences were observed in changes in other negative mood scores between groups. DHA and ARA content in plasma phospholipids were increased by 0.8% and 0.7%, respectively, in the LCPUFA group, and were significantly larger than those in the placebo group. Dietary DHA, EPA, and ARA intake was unchanged during the study. These results suggest that LCPUFA supplementation may improve vigor (positive mood) in elderly Japanese men.

    Be well!


  22. JP Says:

    Updated 10/30/17:

    Behav Res Ther. 2017 Oct 12;99:124-130.

    Brief training in mindfulness meditation reduces symptoms in patients with a chronic or recurrent lifetime history of depression: A randomized controlled study.

    BACKGROUND: Training in mindfulness has been introduced to the treatment of depression as a means of relapse prevention. However, given its buffering effects on maladaptive responses to negative mood, mindfulness training would be expected to be particularly helpful in those who are currently suffering from symptoms. This study investigated whether a brief and targeted mindfulness-based intervention can reduce symptoms in acutely depressed patients.

    METHODS: Seventy-four patients with a chronic or recurrent lifetime history were randomly allocated to receive either a brief mindfulness-based intervention (MBI) encompassing three individual sessions and regular home practice or a control condition that combined psycho-educational components and regular rest periods using the same format as the MBI. Self-reported severity of symptoms, mindfulness in every day life, ruminative tendencies and cognitive reactivity were assessed before and after intervention.

    RESULTS: Treatment completers in the MBI condition showed pronounced and significantly stronger reductions in symptoms than those in the control condition. In the MBI group only, patients showed significant increases in mindfulness, and significant reductions in ruminative tendencies and cognitive reactivity.

    CONCLUSIONS: Brief targeted mindfulness interventions can help to reduce symptoms and buffer maladaptive responses to negative mood in acutely depressed patients with chronic or recurrent lifetime history.

    Be well!


  23. JP Says:

    Updated 10/31/17:

    J Diabetes Res. 2017;2017:8232863.

    Vitamin D Supplementation Improves Mood in Women with Type 2 Diabetes.

    OBJECTIVE: The aim of this study was to determine the effect of vitamin D supplementation on improving mood (depression and anxiety) and health status (mental and physical) in women with type 2 diabetes mellitus (T2DM).

    METHODS: Fifty women with T2DM and significant depressive symptomology were enrolled into the “Sunshine Study,” where weekly vitamin D supplementation (ergocalciferol, 50,000 IU) was given to all participants for six months. The main outcomes included (1) depression (Center for Epidemiologic Studies Depression, CES-D, and Patient Health Questionnaire, PHQ-9), (2) anxiety (State-Trait Anxiety), and (3) health status (Short Form, SF-12).

    RESULTS: Forty-six women (92%) completed all visits. There was a significant decrease in depression (CES-D and PHQ-9, p < 0.001) and anxiety (state and trait, p < 0.001). An improvement in mental health status (SF-12, p < 0.001) was also found. After controlling for covariates (race, season of enrollment, baseline vitamin D, baseline depression (PHQ-9), and body mass index), the decline in depression remained significant (CES-D, p < 0.001). There was a trend for a better response to supplementation for women who were not taking medications for mood (antidepressants or anxiolytics) (p = 0.07). CONCLUSIONS: Randomized trials to confirm that vitamin D supplementation can improve mood and health status in T2DM women are needed. Be well! JP

  24. JP Says:

    Updated 11/12/17:

    Complement Ther Clin Pract. 2017 Nov;29:189-193.

    Diet and lifestyle intervention on chronic moderate to severe depression and anxiety and other chronic conditions.

    This group study explored how an intervention of diet, lifestyle and behavior modification, including a plant-based diet, daily exercise and mindfulness techniques, would affect 500 adult men and women participants diagnosed with chronic moderate to severe depression and anxiety and other conditions during a 12 week period. An analysis of the health outcomes detailed in self-reported diary entries was carried out at the conclusion of the 12 week period. These reports noted improvements in depression, anxiety and all other conditions addressed by the study, with the majority of participants reporting substantial benefits. A six month follow up indicated that these benefits persisted in most of the participants. These results demonstrate that an intervention of diet, exercise, lifestyle and behavior modification may provide considerable benefits for moderate to severe depression and anxiety as well as other conditions.

    Be well!


  25. JP Says:

    Updated 03/05/18:

    Eur J Clin Nutr. 2018 Mar 2.

    Non-alcoholic beverage consumption and risk of depression: epidemiological evidence from observational studies.

    BACKGROUND/OBJECTIVES: Recent epidemiological studies have examined associations between various types of non-alcoholic beverage consumption and risk of depression, but the associations were inconsistent. To provide a quantitative assessment of this association, we performed a systematic review and meta-analysis of observational studies.

    SUBJECTS/METHODS: We searched PubMed and Web of Science databases through February 2017 for eligible studies and examined the reference lists of the retrieved articles. A random-effects model was used to calculate pooled relative risks (RR) with 95% CIs after adjusting for important confounders.

    RESULTS: We identified fifteen observational studies (9 cross-sectional studies; 6 prospective studies) of beverage consumption and depression, including 20,572 cases of depression among 347,691 participants. For coffee and tea consumption, the pooled RRs of depression for the high vs. low categories of consumption were 0.73 (95% CI 0.59-0.90) and 0.71 (95% CI 0.55-0.91), respectively. For soft drinks, however, the pooled RR for the high vs. low category of consumption was 1.36 (95% CI 1.24-1.50). The inverse association with coffee or tea consumption and the positive association with soft drink consumption for risk of depression did not vary by gender, country, high consumption category, and adjustment factors such as alcohol, smoking and physical activity.

    CONCLUSIONS: Our findings suggest that high consumption of coffee and tea may reduce the risk of depression, while high consumption of soft drinks may increase the risk of depression. Further well-designed large prospective studies are needed to provide definitive evidence to address the effects of various types of beverages on risk of depression.

    Be well!


  26. JP Says:

    Updated 06/30/18:

    J Diet Suppl. 2018 Jun 29:1-9.

    Vitamin D Decreases Beck Depression Inventory Score in Patients with Mild to Moderate Ulcerative Colitis: A Double-Blind Randomized Placebo-Controlled Trial.

    The prevalence of depression in inflammatory bowel disease (IBD) is significantly more than in controls. Some studies assessed the link between vitamin D and depression. The aim of this study was to assess the effect of vitamin D on Beck Depression Inventory (BDI) score in ulcerative colitis (UC) patients. In this double-blind randomized controlled trial, 90 mild to moderate UC patients were assigned to receive a single injection of 300,000 IU vitamin D3 or 1 ml normal saline as placebo. At baseline and 3 months later, measurements of BDI score and serum 25-OH-vitamin D3 were done. Data were compared by independent sample t test, Mann-Whitney U test, and analysis of covariance (ANCOVA). Baseline BDI scores were not statistically different between the two groups (p = .4); scores decreased in the vitamin D group after the intervention (p = .023). Further subgroup analysis regarding baseline serum vitamin D levels and adjusted for baseline BDIs revealed lowering effect of vitamin D on BDI scores only in subgroup with baseline serum vitamin D levels equal to or higher than 30 ng/ml (p < .001). In this study, there was a statistically significant reduction in BDI score in mild to moderate UC patients 3 months after 300,000 IU vitamin D3 injection. Subgroup analysis showed that patients with sufficient baseline vitamin D may benefit from supplementation more than vitamin D-deficient patients, which indicates that higher serum vitamin D levels may be needed for its antidepressant effect. Be well! JP

  27. JP Says:

    Updated 03/19/19:

    Benef Microbes. 2019 Mar 18:1-20.

    Lactobacillus plantarum DR7 alleviates stress and anxiety in adults: a randomised, double-blind, placebo-controlled study.

    Probiotics have been reported to exert beneficial effects along the gut-brain axis. This randomised, double-blind and placebo-controlled human study aimed to evaluate such properties of Lactobacillus plantarum DR7 and its accompanying mechanisms in stressed adults. One hundred and eleven (n=111; DR7 n=56, placebo n=55) stressed adults were recruited based on moderate stress levels using the PSS-10 questionnaire. The consumption of DR7 (1×109 cfu/day) for 12 weeks reduced symptoms of stress (P=0.024), anxiety (P=0.001), and total psychological scores (P=0.022) as early as 8 weeks among stressed adults compared to the placebo group as assessed by the DASS-42 questionnaire. Plasma cortisol level was reduced among DR7 subjects as compared to the placebo, accompanied by reduced plasma pro-inflammatory cytokines, such as interferon-γ and transforming growth factor-α and increased plasma anti-inflammatory cytokines, such as interleukin 10 (P<0.05). DR7 better improved cognitive and memory functions in normal adults (>30 years old), such as basic attention, emotional cognition, and associate learning (P<0.05), as compared to the placebo and young adults (<30 years old). The administration of DR7 enhanced the serotonin pathway, as observed by lowered expressions of plasma dopamine β-hydroxylase (DBH), tyrosine hydroxylase (TH), indoleamine 2,3-dioxygenase and tryptophan 2,3-dioxygenase accompanied by increased expressions of tryptophan hydroxylase-2 and 5-hydroxytryptamine receptor-6, while stabilising the dopamine pathway as observed via stabilised expressions of TH and DBH over 12 weeks as compared to the placebo (P<0.05). Our results indicated that DR7 fulfil the requirement of a probiotic strain as per recommendation of FAO/WHO and could be applicable as a natural strategy to improve psychological functions, cognitive health and memory in stressed adults.

    Be well!


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