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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In our Eat2BeNice project, we want to know how lifestyle-factors, and nutrition contribute to impulsive, compulsive, and externalizing behaviours. The best way to investigate this is to follow lifestyle and health changes in individuals for a longer period of time. This is called a prospective cohort study, as it allows us to investigate whether lifestyle and nutrition events at one point in time are associated with health effects at a later point.

Luckily we can make use of the LifeGene project for this. LifeGene is a unique project that aims to advance the knowledge about how genes, environments, and lifestyle-factors affect our health. Starting from September 2009, individuals aged 18 to 45 years, were randomly sampled from the Swedish general population. Participants were invited to include their families (partner and children). All study participants will be prompted annually to respond to an update web-based questionnaire on changes in household composition, symptoms, injuries and pregnancy.

The LifeGene project (1) consists of two parts: First, a comprehensive web-based questionnaire to collect information about the physical, mental and social well-being of the study participants. Nine themes are provided for adults: Lifestyle (including detailed dietary intake and nutrition information), Self-care, Woman’s health, Living habits, Healthy history, Asthma and allergy, Injuries, Mental health and Sociodemographic. The partners and children receive questions about two to four of these themes. For children below the age of 15 the parents are requested to answer the questions for them.

The second part is a health test: at the test centres, the study participants are examined for weight, height, waist, hip and chest circumference, heart rate and blood pressure, along with hearing. Blood and urine samples are also taken at the test centres for analysis and bio-banking.

Up until 2019, LifeGene contains information from a total of 52,107 participants. Blood, serum and urine from more than 29,500 participants are stored in Karolinska Institute (KI) biobank. From these we can analyze genetic data and biomarkers for diabetes, heart disease, kidney disease and other somatic diseases. Based on LifeGene, we aim to identify nutritional and lifestyle components that have the most harmful or protective effects on impulsive, compulsive, and externalizing behaviors across the lifespan, and further examine whether nutritional factors are important mediators to link impulsivity, compulsivity and metabolic diseases(e.g. obesity, diabetes). We will update you on our results in the near future.

For more information, please go to the LifeGene homepage www.lifegene.se. LifeGene is an open-access resource for many national and international researchers and a platform for a myriad of biomedical research projects. Several research projects are underway at LifeGene https://lifegene.se/for-scientists/ongoing-research/.

This was co-authored by Henrik Larsson, professor in the School of Medical Science, Örebro University and Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Sweden.

AUTHORS:
Lin Li, MSc, PhD student in the School of Medical Science, Örebro University, Sweden.

Henrik Larsson, PhD, professor in the School of Medical Science, Örebro University and Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Sweden.

REFERENCES:

  1. Almqvist C, Adami HO, Franks PW, Groop L, Ingelsson E, Kere J, et al. LifeGene–a large prospective population-based study of global relevance. Eur J Epidemiol. 2011;26(1):67-77.
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Cigarette smoking may give immediate pleasure but is dangerous for your health. Smoking may be seen as a way to deal with feelings like anxiety and stress and may be viewed as a way of coping with everyday life. Smoking a cigarette may also be used as a reward, and as part of a celebration of big and small victories. But what happens to your mental well-being if you quit smoking?

Smoke cessation is one of the best things, if not the best, you can do for your health! Smoking is ranked as the second leading cause of death by a body called “the Global Burden of Disease 2017 Risk Factor Collaborators”.1 Quitting smoking lowers your risk of cardiovascular diseases and your risk of cancer. 2 But does this come at a price concerning your mental health – how is that impacted by quitting smoking?

A systematic review of 26 studies assessing mental health before and after smoking cessation found that quitting was associated with mental health benefits. 3 Assessment of mental health were made both in the general population and in clinical populations, including persons with physical or psychiatric conditions. In the included studies, the assessment of mental status at least 6 weeks after cessation was compared with the baseline assessment. Smoking cessation was associated with improvements in levels of anxiety, depression, stress and psychological quality of life. The authors point to clinicians to recommend smoking cessation interventions also among smokers with mental health problems.

There are several aides to be used by smoke quitters. These span from brief advice to nicotine replacement therapy. How do you get help for smoking cessation? Talk to your doctor about it! And don’t give up if you fail at a quit attempt! Each attempt will bring you closer to the status “former smoker”.

REFERENCES:

  1. Collaborators GBDRF. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018;392:1923-94.
  2. https://www.who.int/tobacco/quitting/benefits/en/
  3. Taylor G, McNeill A, Girling A, Farley A, Lindson-Hawley N, Aveyard P. Change in mental health after smoking cessation: systematic review and meta-analysis. BMJ 2014;348:g1151. https://www.bmj.com/content/348/bmj.g1151

 

 

 

 

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