What is vitamin B1 (thiamine)?

Thiamine, which is also known as vitamin B1, is an essential micronutrient, which is required for metabolism, enzymatic processes and conduction of nerve signals. All living organisms use thiamine, but it can be made only in bacteria, fungi and plants. In humans, gastrointestinal microbiota also produces thiamine, but not enough for the organism functioning. Thus, we, as well as other animals must obtain vitamin B1 from the diet.

Thiamine deficiency

Deficiency of thiamine can affect the cardiovascular, nervous and immune systems. A severe and chronic form is known as beriberi. Wet beriberi affects cardiovascular system resulting in tachycardia, high arterial and venous pressures, leg swelling. Dry beriberi affects nervous system resulting in impairment of sensory, motor and reflex functions and altered mental status. Worldwide thiamine deficiency is most widely reported in populations where primary food source are polished rice and grains. In Western countries, it most commonly affects people suffering from alcoholism or chronic illness. Thiamine deficiency in patients with alcohol use disorder often lead to Kosakoff syndrome, a chronic disease with severe memory loss and learning problems.

Food sources of thiamine

It is very easy to add foods rich with thiamine to the diet. Food sources of thiamine include beef, pork, eggs, liver, nuts, oats, oranges, seeds, legumes and yeast. Such foods as rice, pasta, breads, cereals and flour are often fortified with vitamin B1 as the processing involved in creating these products removes thiamine. Thiamine supplements and medications are available on market to treat or prevent thiamine deficiency. Remarkably, B1 is well tolerated and has almost no side effects.

Bioavailable analogues of Thiamine

Analogues of vitamin B1, such as benfotiamine or dibenzoyl thiamine, have improved bioavailability, due to their higher lipid solubility, which facilitate permeation in cell membranes. As a result, they provide higher levels of thiamine in muscle, brain and liver. This can be the reason of their higher effectiveness.

Thiamine as medication

Thiamine was the first of the water-soluble vitamins to be discovered, and since early 20th century it was extensively studied. Most commonly thiamine supplementation is used to treat syndromes associated with severe thiamine deficiency and during pregnancy and lactating due to increased need for this vitamin. Rapid recovery can occur within hours if thiamine is given intravenously. If concentrated thiamine supplements are not available, diets rich with thiamine will also lead to recovery, though at a slower rate.

New properties of thiamine

Recently, other important roles of thiamine including the regulation of oxidative stress were discovered [1]. As emotional stress is associated with oxidative stress in the brain, it was hypothesized that thiamine can counteract negative effects of the stress. And indeed, in studies on mice thiamine precluded negative changes in mood and emotionality, as well as neuroinflammation and oxidative stress caused by stress [2,3]. It also ameliorated cellular proliferation and neurogenesis in the hippocampus under stress conditions. In agreement with animal studies, vitamin B1 was also able to ameliorate symptoms of major depressive disorder in patients [4] or work stress-related mood swings [5].

Thus, thiamine was shown as a promising treatment for the depressive-like changes and excessive aggression, caused by stress. Hopefully, new studies on thiamine will be conducted in the nearest future to show novel properties of this vitamin.

 

References

[1]      L. Bettendorff, P. Wins, Biological functions of thiamine derivatives: Focus on non-coenzyme roles, OA Biochem. 1 (2013).

[2]      N. Markova, N. Bazhenova, D.C. Anthony, J. Vignisse, A. Svistunov, K.-P. Lesch, L. Bettendorff, T. Strekalova, Thiamine and benfotiamine improve cognition and ameliorate GSK-3β-associated stress-induced behaviours in mice, Prog. Neuro-Psychopharmacology Biol. Psychiatry. 75 (2017) 148–156.

[3]      A. Gorlova, D. Pavlov, D.C. Anthony, E.D. Ponomarev, M. Sambon, A. Proshin, I. Shafarevich, D. Babaevskaya, K.-P. Lesсh, L. Bettendorff, T. Strekalova, Thiamine and benfotiamine counteract ultrasound-induced aggression, normalize AMPA receptor expression and plasticity markers, and reduce oxidative stress in mice, Neuropharmacology. (2019).

[4]      A. Ghaleiha, H. Davari, L. Jahangard, M. Haghighi, M. Ahmadpanah, M.A. Seifrabie, H. Bajoghli, E. Holsboer-Trachsler, S. Brand, Adjuvant thiamine improved standard treatment in patients with major depressive disorder: results from a randomized, double-blind, and placebo-controlled clinical trial, Eur. Arch. Psychiatry Clin. Neurosci. 266 (2016) 695–702.

[5]      C. Stough, A. Scholey, J. Lloyd, J. Spong, S. Myers, L.A. Downey, The effect of 90 day administration of a high dose vitamin B-complex on work stress, Hum. Psychopharmacol. Clin. Exp. 26 (2011) 470–476.

 

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Superfoods

Chia Who? – The Superfood Trend
I have a green smoothie every morning with chia seeds and acai berries, you should try it too! I feel so fit and healthy!” Have you ever heard this or a similar sentence in your life? In recent years, more and more people have been talking about superfoods. There are many new restaurants with superfoods on the menu and a sharp increase in coverage of superfoods in beauty, health and nutrition magazines. Increasing concerns about health and aging society appear to be an important driver of the superfood trend in Europe, as a rapid rise in new products enters a dynamic and growing market. Every season new products are introduced and advertised as superfoods. The United States are in first place at importing goods labeled as superfood, Germany ranks second (4).

But what are superfoods exactly and what makes it so “super” and different from functional food?
Superfood can be defined as food that is considered particularly nutritious and energy-dense. Foods that fall into this category include chia seeds, acai berries, blueberries, beetroot, soy, pomegranates, green tea, goji berries, coconut oil, salmon, dark chocolate, cocoa and kale (2). Some of these superfoods, like chia seeds or goji berries, have turned into established products that can be obtained in almost every supermarket or even in discounters. Among the superfoods, goji is the leading superfood product. “Goji” is the generic name for different plant species from the genus lycium (2). However, superfood is neither a registered trademark nor a legally protected term. All definitions have in common that they describe superfoods as a food that has a high nutrient density. This means a comparatively high amount of e.g. proteins, vitamins, minerals, polyunsaturated fatty acids, phytochemicals, and antioxidants. The problem is, however, that many of these products are extremely damaged by pollutants that can have even negative effects on our health. Also, they usually have long transport routes behind them, which is not only bad for the climate but can also decrease the nutrient density.

So what’s the conclusion and the recommendation?
Overall, superfoods are a good thing, but superfoods should not emphasize some single representatives or nutrients, because the variety and complexity of the entire nutrition is important for a healthy lifestyle. In addition, it depends on the lifestyle in general, so a lot of exercise, sufficient sleep, social contacts and a positive attitude to your life are key (3). A healthy diet with a lot of fruits and vegetables has not only positive effects on your physical health; it also has a significant influence on your psychological well-being. Therefore it is not only worthwhile for your body but also for the mind to significantly increase your personal fruit and vegetable consumption. It is crucial that your diet includes essential vitamins and nutrients which can help in relieving symptoms of depression, mood disorders, and other mental illnesses (6).

For some, lifestyle might be considered more important than sustainability at this point, because many local products like blackberries, linseeds, or peppers offer the same high vitamin content as superfoods, but do not have the wonderful image of superfood (1). So if you want to buy superfoods like goji berries or chia seeds, it makes sense to buy certified organic products. They are manufactured without the use of chemical pesticides and fertilizers. The Fairtrade seal is also a guarantee of more sustainability for products from distant countries. And don’t forget that agriculture in Germany and Europe also has many local “superfoods” to offer. Flax seeds, for example, are a real good alternative to chia seeds because they have similar “slime forming” properties.

Certainly, the trendy superfood products have many beneficial properties for our health. But the native fields provide all the vitamins that you need, too, often at a much lower price. For a healthy diet, berries (for example) are not required. Those who eat a varied and balanced diet can do it also with local fruits and vegetables. It is worthwhile in many ways to look for fresh, seasonal and organically grown fruits and vegetables on the market! And anyway – self harvested “superfood” tastes the best! (5).

REFERENCES:

  1. Ortner, J. (2018). In aller Munde – eine soziodramatische Betrachtung der Ernährung. Wiesbanden: Springer
  2. Wetters, S., Horn, T., Nick, P. (2018) Goji Who? Morphological and DNA Based Authentication of a “Superfood”.  Plant Sci.9:1859. doi: 10.3389/fpls.2018.01859
  3. Feichtinger, J. (2019). Heimisches Superfood: regional und nährstoffreich. In: Ernährung & Medizin 34(03):147-155
  4. Sikka, T. (2017). Contemporary Superfood Cults: Nutritionism, Neoliberalism, and Gender. In: Cargill, K. (2017). Food Cults. How Fads, Dogma, and Doctrine influence Diet. Maryland: Rowman & Littlefield
  5. https://www.oekolandbau.de/bio-im-alltag/einkaufen-und-kochen/trends-und-tests/superfoods/
  6. https://www.zentrum-der-gesundheit.de/news/gesunde-ernaehrung-psychisches-wohlbefinden-170204017.html
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Have you ever done your weekly grocery shopping and ended up with more than actually written on your grocery list?
Everybody has at least once experienced how it is to buy food in a supermarket with hunger and buy much more than planned. The widely known recommendation: Never go grocery shopping when you are hungry!!!

But is it only a myth or is there a grain of truth in that advice?
What exactly is the issue with going grocery shopping when you are hungry? If you do you probably buy more food than you need and planned to buy. Additionally, unhealthy food might be much more attractive for you than healthy food. The consequence: you have more food at home, so you might eat more and unhealthier. Imagine you are hungry and are coming home from work after a stressful day and now you get to choose between a frozen pizza and a healthy meal that has not been prepared yet – What would you choose? In that situation, I think I would definitely choose the frozen pizza.

High-calorie food and unhealthy food are associated with obesity. Obesity research found a moderate relationship between obesity and emotional disorders like depressive disorder and anxiety disorder (1). Thus, having fast food frequently might not only affect your physical, but also your mental well-being.

Let’s rewind to grocery shopping, but now consider you are not hungry. You probably would only buy the things that are on your grocery list, and also rather healthy food than an unhealthy one. So now you come home hungry from a stressful day at work and you don’t have the choice between healthy and unhealthy food, and the temptation of the frozen pizza isn’t there. So you would start to prepare your healthy food and thus automatically eat healthier.

Coming back to the question if these scenarios are devised or true, and thus representative for weekly grocery shopping.
Research has shown that impulsivity, obesity, and food buying behavior are related. People with obesity are more impulsive than slim people. Also, impulsive people eat more than less impulsive people. Hunger influences food buying behavior and food consumption, especially of high caloric food. The relationship between impulsivity and buying food might be state dependent: researchers have found that impulsive people bought more calories, especially from snack food, but only when they were feeling hungry. This means that impulsivity and hunger interact in their influence on consumption. Obese people are found to show a preference for energy-dense, high-fat food and eat more of these foods, compared to slim people (2).

So what’s the conclusion?
Yes, hunger influences your grocery shopping, especially in interaction with impulsivity. If you consider yourself an impulsive person, you might be more prone to buying more than intended when you go shopping hungry.

So if you have the chance: only go shopping for groceries when you are full and focused. If you accidentally get into a hungry grocery shopping situation, keep this blog in mind and try to focus on your grocery list.

REFERENCES:
Scott, K. M., Bruffaerts, R., Simon, G. E., Alonso, J., Angermeyer, M., de Girolamo, G., … & Kessler, R. C. (2008). Obesity and mental disorders in the general population: results from the world mental health surveys. International journal of obesity32(1), 192.

Nederkoorn, C., Guerrieri, R., Havermans, R. C., Roefs, A., & Jansen, A. (2009). The interactive effect of hunger and impulsivity on food intake and purchase in a virtual supermarket. International journal of obesity33(8), 905.

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Recently I had a great chance to participate in the 19th WPA World Congress of Psychiatry which took place in Lisbon 21-24 of August 2019. Such an international scientific event summarizes recent findings and sets a trend for future research.

The effect of lifestyle on mental health was one of the topics discussed at the conference. Focusing on nutritional impact in psychiatry I will review here some of the studies – research done in animal models or patients and literature reviews – which were presented at the Congress.

All the poster presentations can be viewed on the conference website https://2019.wcp-congress.com/.

Dietary patterns and mental health

  1. Sanchez-Villegas and colleagues from Spain1 presented research on the Mediterranean diet’s effects in patients recovered from depressive disorders. They found that adherence to Mediterranean diet supplemented with extra-virgin olive oil led to the improvement of depressive symptoms. This new study supports previous reports about positive effects of traditional dietary patterns compared to so-called “Western diet”, and this topic was nicely reviewed in the poster presentation of M. Jesus and colleagues (Portugal)2.

I presented a poster3 on a study done in a mouse model of Western diet feeding. We found that genetic deficiency of serotonin transporter exacerbates metabolic alterations and such behavioural consequences of the Western diet as depressive-like behaviour and cognitive impairment. In human, carriers of a genetic variant that reduces serotonin transporter expression are known to be more susceptible to emotionality-related disorders and prone to obesity and diabetes.

Vitamin D and Mental Health

Nutritional psychiatry was traditionally focused on the effects of vitamins and micronutrients on mental health. Several presentations at this conference were dedicated to the role of vitamin D in mental disorders.

Scientists from Egypt (T. Okasha and colleagues)4 showed their results on the correlation between serum level of vitamin D and two psychiatric disorders: schizophrenia and depression. They found lower serum vitamin D levels in the patients with schizophrenia or depression compared to healthy volunteers. These findings indicate a role of vitamin D in the development of psychiatric disorders.

However, the team from Denmark (J. Hansen and colleagues)5 did not find any effect of 3 months vitamin D supplementation on depression symptoms in patients with major depression. The contrariety of the studies on vitamin D benefits in mental health was presented on the review poster by R. Avelar and colleagues (Portugal)6.

Microbiome and Mental Health

There is increasing evidence that microbiota-gut-brain axis influences behaviour and mental health. N. Watanabe and colleagues (Japan)7 presented the results of a study on germfree and commensal microbiota-associated mice. They found increased aggression and impaired brain serotonin metabolism in germfree mice.

  1. Dias and colleagues (Portugal)8 performed a literature review on this topic exploring possible effects of microbiome and probiotics in mental disorder development. The most robust evidence was found for the association of microbiome alterations and depression/anxiety. Up to date literature is lacking replicated findings on proving positive effects of probiotics in mental disorders treatment.

Diabetes Type 2 and Mental Disorders

Risk factors for type 2 diabetes include diet and lifestyle habits. It is getting more obvious that there is an association between type 2 diabetes and the development of mental disorders.

  1. Mhalla and colleagues (Tunisia)9 reported a study done on patients with type 2 diabetes. They found a high prevalence of depression in women with type 2 diabetes. Also, depression in these patients was associated with poorer glycemic control.

Depression is an important factor influencing insomnia. H.C. Kim (Republic of Korea)10 found insomnia in one-third of patients with diabetes type 2.

The group from Romania (A. Ciobanu and colleagues)11 created a meta-analysis of the medical literature showing an association of diabetes type 2 with Alzheimer’s disease. They highlighted the role of insulin signaling in cognition and proposed glucose blood level control as a therapeutic approach in Alzheimer’s disease.

 

Thus, a lot of studies were recently done on the role of nutrition in psychiatric disorders development and therapy. However, there is still room for future discoveries!

REFERENCES:
From 19th WPA World Congress of Psychiatry proceedings:

  1. Sanchez-Villegas, B. Cabrera-Suárez, M. Santos Burguete, P. Molero, A. González-Pinto, C. Chiclana, J. Hernández-Fleta. INTERVENTION WITH MEDITERRANEAN DIET IN THE IMPROVEMENT OF DEPRESSIVE SYMPTOMS IN PATIENTS RECOVERED FROM DEPRESSIVE DISORDER. PREDI-DEP TRIAL PRELIMINARY RESULTS;
  2. Jesus, C. Cagigal, T. Silva, V. Martins, C. Silva. DIETARY PATTERNS AND THEIR INFLUENCE IN DEPRESSION;
  3. Veniaminova, A. Gorlova, J. Hebert, D. Radford-Smith, R. Cespuglio, A. Schmitt-Boehrer, K. Lesch, D. Anthony, T. Strekalova. THE ROLE OF GENETIC SEROTONIN TRANSPORTER DEFICIENCY IN CONSEQUENCES OF EXPOSURE TO THE WESTERN DIET: A STUDY IN MICE;
  4. Okasha, W. Sabry, M. Hashim, A. Abdelrahman. VITAMIN D SERUM LEVEL AND ITS CORRELATION WITH MAJOR DEPRESSIVE DISORDER AND SCHIZOPHRENIA;
  5. Hansen, M. Pareek, A. Hvolby, A. Schmedes, T. Toft, E. Dahl, C. Nielsen7, P. Schulz8. VITAMIN D3 SUPPLEMENTATION AND TREATMENT OUTCOMES IN PATIENTS WITH DEPRESSION;
  6. Avelar, D. Guedes, J. Velosa, F. Passos, A. Delgado, A. Corbal Luengo, M. Heitor. VITAMIN D AND MENTAL HEALTH: A BRIEF REVIEW;
  7. Watanabe, K. Mikami, K. Keitaro, F. Akama, Y. Aiba, K. Yamamoto, H. Matsumoto. INFLUENCE OF COMMENSAL MICROBIOTA ON AGGRESSIVE BEHAVIORS;
  8. Dias, I. Figueiredo, F. Ferreira, F. Viegas, C. Cativo, J. Pedro, T. Ferreira, N. Santos, T. Maia. EMOTIONAL GUT: THE RELATION BETWEEN GUT MICROBIOME AND MENTAL HEALTH;
  9. Mhalla, M. Jabeur, H. Mhalla, C. Amrouche, H. Ounaissa, F. Zaafrane3, L. Gaha. DEPRESSION IN ADULTS WITH TYPE 2 DIABETES: PREVALENCE AND ASSOCIATED FACTORS;
  10. Kim. FACTORS RELATED TO INSOMNIA IN TYPE 2 DIABETICS;
  11. A. Ciobanu, L. Catrinescu2, C. Neagu3, I. Dumitru3. THE CONNECTION BETWEEN ALZHEIMER’S DISEASE AND DIABETES

 

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According to the food and agriculture organization, about 1 billion people in the world were living in hunger or insecurity in the year 2010 (1). Additionally, 5 to 15 % of people in industrial countries experience food insecurity which makes it all the more a public health concern in Europe (2).

But, what exactly is food insecurity about?

Food insecurity means that the access to sufficient food, meeting the dietary and cultural needs and the individual food preferences for a healthy and active life is not possible. It is not only a lack of food, what`s more, is the feeling that the preferred food supply is not available or may be threatened in the future, which has, in turn, an effect on the eating behavior. That means even if food is sufficient, people may be food insecure, but not necessarily undernourished. Two risk groups are students, who do not have the money for buying their preferred food, and refugees, who can´t buy their traditional food in their new home towns. Food insecurity can result in a reduction on micro-and macronutrition intake. Macronutrients are large food components that the body needs to maintain its metabolism; it includes lipids (fats), sugars (carbohydrates) and proteins. Micronutritions, like vitamins, minerals (such as calcium or magnesium), trace elements (such as iron and zinc), are essential because, without them, numerous normal functions such as growth or energy production could not take place.

Effects on mental health

Food insecurity is also found more often in families with low social economic status (4). Researchers have found that food insecurity caused an increase of depression and anxiety symptoms (3). Furthermore the uncertainty of having food in the future produced stress and created desperation and hopelessness in the families. They perceived the situation as shameful and resigned or used drugs and alcohol to compensate. In addition to this ,children from food insecure families were also more likely to develop symptoms of depression/ anxiety, aggression and hyperactivity/inattention (2). However, when you control for many demographical and psychological variables such as immigrant status, family structure and income and paternal depression, only increased impulsive behavior and inattention seem to be specifically linked to food insecurity Another factor is maternal mental health. It has been shown that food insecurity is especially bad for children’s development if the mother has additional mental health problems like depression, domestic violence and psychosis.

Further insights can be derived from Canadian students (5). Here are financial constraints a primary contributing factor. It represents a barrier because often students can´t afford to buy qualitative and expensive food. Another important factor is insufficient time because the effort to buy, prepare and cook healthy meals takes time and requires planning. It may also be the limited access to culturally appropriate food. This could be a barrier especially for people from other countries, who don´t have the opportunity to buy their traditional food and spices in local supermarkets. In urban areas, more exotic and international food supply is possible, due to the higher demand. The consequences for students were feelings of shame, frustration and loneliness. Some have felt socially isolated, and in general the food insecurity was associated with high psychological stress. Nonetheless the students in the reports believed that the situation is temporary and that after university life gets better in terms of food quantity and quality. For now they accepted the current situation.

So overall, food insecurity may occur in different social classes, with different reasons and effects of varying intensity. It`s interesting to see that it can occur in developing countries and rich countries, and that it can have an influence on whole families and children of food insecure families and students. More studies about people with cultural issues (e.g. refugees) are needed.

So, if you have the chance:

Buy the food you prefer and take time for preparing your meal,                      to live your life as healthy as you want it to be!

REFERENCES

(1) Cole, S. M.; Gelson, T. (2011). The effect of food insecurity on mental health: Panel evidence from rural Zambia. Social Science & Medicine. 73 (7)1071-1079.

(2) Melchior M.; Chastang J.- F.; Falissard B.; Galera, C.; Tremblay, R.E.; Cote, S.M., Boivin, M. (2012). Food insecurity and children’s mental health: a prospective birth cohort study. PLoS One 7 (12).

(3) Weaver, L. J.; Hadley. C. (2009) Moving Beyond Hunger and Nutrition: A Systematic Review of the Evidence Linking Food Insecurity and Mental Health in Developing Countries, Ecology of Food and Nutrition, 48(4), 263-284.

(4) Melchior, M.; Caspi, A.; Howard, L.M.; Ambler, A.P.; Bolton, H.; Mountain, N; Moffitt, T.E. (2009) Mental health context of food insecurity: a representative cohort of families with young children. Pediatrics, 124 (4).

(5) Hattangadi, N.; Vogel, E.; Carroll, L. J.; Cote, T. (2019). “Everybody I Know Is Always Hungry…But Nobody Asks Why”: University Students, Food Insecurity and Mental Health. Sustainability. 11 (6).

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Behavior results from the complex interplay between genes and environment. Our genes predispose us to how we act and feel, by influencing how our brain develops and functions. This way, certain genetic variants in our genome increase the risk of developing mental health problems (while others may decrease this risk). Whether someone actually develops a mental health disorder or not, depends on many other factors in our environment, such as stressors and experiences. Nonetheless, studying these genetic risk factors for mental health conditions is an important aspect of understanding these disorders.

As an example of such research, we have now identified several genetic risk factors that contribute to cocaine dependence. For this we combined genetic data from a lot of studies, including more than 6000 individuals. What’s even more interesting is that we found that the genetic variants that are related to cocaine dependence are correlated with the genetic risk factors for other conditions such as ADHD, schizophrenia and major depression. What this means is that certain small variations in DNA increase the risk for not just cocaine dependence, but actually several psychiatric conditions. Probably, there is a common biological mechanism that underlies all these conditions. Thanks to our genetic research, we are now only a small step closer towards unraveling these mechanisms.

We also wrote a blog post explaining our research findings. You can read it here: https://mind-the-gap.live/2019/07/04/cocaine-dependence-is-in-part-genetic-and-it-shares-genetic-risk-factors-with-other-psychiatric-conditions-and-personality-traits/

The original publication can be found here: https://www.sciencedirect.com/science/article/pii/S0278584619301101?via%3Dihub

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Feeling more happy after a run? Or feeling a bit blue during the dark winter days? Regular exercising and regular daylight exposure can influence your mood, behaviour and sleep-wake cycle 1,2,3. But can this also be used in a therapeutical setting, for instance in addition to or instead of the usual treatment with medication?

The PROUD trial aims to investigate the potential of bright light therapy and physical exercise to improve and prevent depression and obesity in adolescents and young adults with ADHD. This clinical trial is part of the CoCA research project, in which comorbid conditions of ADHD are investigated [insert hyperlink: https://coca-project.eu/coca-phase-iia-trial/study/]. In addition, we collect the stool samples of all participants in order to investigate the effects of physical exercise on the gut microbiome and how this is linked to behaviour. That part of the study is part of the Eat2beNICE research project.

Most people with Attention Deficit Hyperactivity Disorder (ADHD) receive medication to reduce their symptoms4. While this medication works well for many people, there is a lot of interest in other types of treatment. One reason for this is that people with ADHD suffer from additional conditions, such as depression5 and obesity6. The risk for developing these comorbid conditions is especially high during adolescence and young adulthood4.

Adolescents and young adults (age 14-45) with ADHD that want to participate are randomly assigned to one of three groups: 10-weeks of daily light therapy (30 minutes), 10-weeks of daily physical exercise (3x per day) or 10-week care as usual (for instance, the normal medication). The random assignment is very important here in order to compare the different interventions. We don’t want to have all people that like sports in the physical exercise group, because then we don’t know if the effects of the physical exercise are due to the intervention, or due to the fact that these people just like sports better.

Another nice feature of the study is that it uses a phone app (called m-Health). This app is used to remind the participants to do their exercise or light therapy, but it also gives feedback and summaries of how the participant is doing. The app is linked to a wrist sensor that measures activity and light.

The clinical trial is currently ongoing in London (England), Nijmegen (Netherlands), Frankfurt (Germany) and Barcelona (Spain). We can’t look at the results until the end of the trial, so for those we will need to wait until 2021. But in the mean time the PROUD-researchers have interviewed four participants. You can read these interviews here:

This blog is based on the blog “10 weeks of physical exercise or light therapy: what’s it like to participate in our clinical trial?” by Jutta Mayer and Adam Pawley, 9 Oct. 2018 on MiND the Gap – https://mind-the-gap.live/2018/10/09/10-weeks-of-physical-exercise-or-light-therapy/

REFERENCES

  1. Terman, M. Evolving applications of light therapy. Sleep Medicine Reviews. 2007; 11(6): 497-507.
  2. Stanton, R. & Reaburn, P. Exercise and the treatment of depression: A review of the exercise program variables. Journal of Science and Medicine in Sport. 2014; 17(2):177-182
  3. Youngstedt, S.D. Effects of exercise on sleep. Clinical Sports Medicine. 2005; 24(2):355-365.
  4. Cortese S, Adamo N, Del Giovane C, Mohr-Jensen C, Hayes AJ, Carucci S, et al. Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. Lancet Psychiatry. 2018;5(9):727-738.
  5. Jacob CP, Romanos J, Dempfle A, Heine M, Windemuth-Kieselbach C, Kruse A, et al. Co-morbidity of adult attention-deficit/hyperactivity disorder with focus on personality traits and related disorders in a tertiary referral center. Eur Arch Psychiatry Clin Neurosci. 2007;257:309–17.
  6. Cortese S, Moreira-Maia CR, St Fleur D, Morcillo-Penalver C, Rohde LA, Faraone SV. Association between ADHD and obesity: a systematic review and meta-analysis. Am J Psychiatry. 2016;173:34–43.
  7. Meinzer MC, Lewinsohn PM, Pettit JW, Seeley JR, Gau JM, Chronis-Tuscano A, et al. Attention-deficit/hyperactivity disorder in adolescence predicts onset of major depressive disorder through early adulthood. Depress Anxiety. 2013;30:546–53
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Recently, I participated in the Radboud Talks 2019, a scientific pitch competition, where I was lucky to be one of the eight finalists.

Why Radboud Talks? It is a perfect opportunity to share my work/ideas with the world and to gain more experience regarding presentation skills. They organized two workshops beforehand, where I had the opportunity to learn presentation techniques from professionals (actors and science communication advisors). We also received a lot of feedback, so I really learned a lot about how to present my scientific work to a general audience.

Below you can find the video from the preliminaries based on which I was chosen as a finalist. There you can hear about my research project which is about gut bacteria and their potential role in ADHD (Attention Deficit Hyperactivity Disorder). ADHD is a common worldwide neurodevelopmental disorder. Every person with ADHD has a unique combination of symptoms and challenges. Importantly, it has a significant social impact on patients’ lives, causing disruption at school, work and relationships. Despite its societal importance, progress in understanding disease biology has been slow.

 

The study of the human microbiome has become a very popular topic, because of their revealed importance in human physiology and health maintenance. Numerous studies have reported that gut bacteria may have an effect on our mental health. Some studies showed a potential role of gut bacteria in a psychiatric disorder like depression, autism or Parkinson (1). Above all, diet showed to have a profound effect of ADHD symptoms. This was earlier described in this blog: https://newbrainnutrition.com/investigating-the-effects-of-a-dietary-intervention-in-adhd-on-the-brain/ and we know that diet is one of the main factors influencing gut bacteria. Taking all together, I am curious (and investigating) if gut bacteria play a role in ADHD and if yes what kind of effect do they have on ADHD symptoms.

REFERENCES:
Bastiaanssen, T., Cowan, C., Claesson, M. J., Dinan, T. G., & Cryan, J. F. (2018). Making Sense of … the Microbiome in Psychiatry. The international journal of neuropsychopharmacology22(1), 37–52. doi:10.1093/ijnp/pyy067

 

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Our body is colonized by trillions of microorganisms that are important for vital processes. Gut microbiota are the microorganisms living in the intestinal gut and play an essential role in digestion, vitamin synthesis and metabolism, among others. The mouth and the large intestine contain the vast majority of gut microbiota whether the stomach only contains few thousands of microorganisms, especially due to the acidity of its fluids. Microbiota composition is constantly changing, affecting the well-being and health of the individual.

Each individual has a unique microbiota composition, and it depends on several factors including diet, diseases, medication and also the genetics of the individual (host) (Figure). Some medicines, especially antibiotics, reduce bacterial diversity. Strong and broad spectrum antibiotics can have longer effects on gut microbiota, some of them up to several years. Genetic variation of an individual also affects the microbiota composition, and the abundance of certain microorganisms is partly genetically determined by the host.

The main contributor to gut microbiota diversity is diet, accounting for 57% of variation. Several studies have demonstrated that diet’s composition has a direct impact on gut microbiota. For example, an study performed on mice showed that “Western diet” (high-fat and sugar diet), alters the composition of microbiota in just one day! On the other hand, vegetarian and calorie restricted diet can also have an effect on gut microbiota composition.

Prebiotics and probiotics are diet strategies more used to control and reestablish the gut microbiota and improve the individual’s health. Probiotics are non-pathogenic microorganisms used as food ingredients (e.g. lactobacillus present in yoghurt) and prebiotics are indigestible food material (e.g. fibers in raw garlic, asparagus and onions), which are nutrients to increase the growth of beneficial microorganisms.

In the last years the new term psychobiotics has been introduced to define live bacteria with beneficial effects on mental health. Psychobiotics are of particular interest for improving the symptomatology of psychiatric disorders and recent preclinical trials have show promising results, particularly in stress, anxiety and depression.

Overall, these approaches are appealing because they can be introduced in food and drink and therefore provide a relatively non-invasive method of manipulating the microbiota.

AUTHORS:
Judit Cabana-Domínguez and Noèlia Fernàndez-Castillo

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ADHD and Exercise

ADHD is among the most common psychiatric disorders, with ~3% prevalence in adulthood and ~5% in childhood. ADHD has a high risk for comorbid conditions. Comorbid means that one psychiatric disorder often comes together with another psychiatric disorder. For instance mood, anxiety and substance use disorders have high comorbid rates in adults with ADHD.

Adults with ADHD are also at risk for obesity and major depressive disorders and adolescent ADHD predicts adult obesity: 40% of adults with ADHD are also obese. These are worrying numbers. Many adults who have ADHD suffer from these negative consequences that come with their mental illness.

There is a growing body of scientific evidence of the powerful effects of nutrition and lifestyle on mental health. Exercise is one of them.It helps prevent or manage a wide range of health problems and concerns, including stroke, obesity, metabolic syndrome, type 2 diabetes, depression, a number of types of cancer and arthritis. Besides that, regular exercise can help you sleep better, reduce stress, sharpen your mental functioning, and improve your sex life. Nearly all studies revolve around aerobic exercise which includes walking, jogging, swimming, and cycling.

Recent research shows that exercise might also have a positive effect on ADHD symptoms such as improving attention and cognition1,2 Additional research is needed to explore this effect further, but we can take a look at the mechanisms underlying this effect.

One of the parts in our brain that is affected by exercise is the prefrontal cortex. The prefrontal cortex plays an important role in controlling impulsive behavior and attention, and is positively influenced by exercise. Furthermore, dopamine and norepinephrine play an important role in attention regulation. Ritalin, among one of the most well-known medication for ADHD, also increases levels of dopamine.

When you exercise regularly, the basis levels of dopamine and norepinephrine rise, and even new dopamine receptors are created. These dopamine levels are also the reason why exercise therapy can be effective for people suffering from depression: low levels of dopamine are a predictor of depressive symptoms.

Taken together: people with ADHD are at risk for obesity and depression. Exercise has a positive influence on obesity, depression and ADHD. Wouldn’t it be great if we could treat people with ADHD with an exercise therapy?

The PROUD-study is currently studying the prevention of depressive symptoms, obesity and the improvement of general health in adolescents and young-adults with ADHD. PROUD establishes feasibility and effect sizes of two kinds of interventions: an aerobic exercise therapy and the effects of a bright light therapy.

Exercise and ADHDParticipants follow a 10 week exercise intervention in which they train three days a week: one day of only aerobic activities (20-40 min) and in two of these days, muscle-strengthening and aerobic activities (35 – 60 min). An app guides them through the exercises, and the intensity and duration of these exercises increase gradually. During a 24 week course changes in mood, condition, ADHD symptoms and body composition are measured.

I am really looking forward to the results of the effectiveness of this intervention in adolescents and adults with ADHD. It is great that this study tries to alter a lifestyle instead of temporarily symptom-reducing options. A healthy life is a happy life!

For more information about the PROUD-study see www.adhd-beweging-lichttherapie.nl (only in Dutch) or contact the researchers via proud@karakter.com. For more information about a healthy lifestyle and the positive effects on mental health, see our other blogs at https://newbrainnutrition.com/

 

References

  1. Kamp CF, Sperlich B, Holmberg HC (2014). Exercise reduces the symptoms of attention-deficit/hyperactivity disorder and improves social behaviour, motor skills, strength and neuropsychological parameters. Acta Paediatrica, 103, 709-714.

 

  1. Choi JW, Han DH, Kang KD, Jung HY, Renshaw, PF (2015). Aerobic exercise and attention deficit hyperactivity disorder: brain research. Med Sci Sports Exerc, 47, 33-39.
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