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Archive of ‘depression’ category

Flaxseeds: single most important food for mental health?

flax-seeds

by R. Aiken MD PhD @rcaiken

Flaxseed helps lower cholesterol, lowers blood pressure, is anti-inflammatory, has good anti-oxidants, and fiber.  It is the single most neuroprotective food; oh yes, then there is the omega-3 content.

There is no doubt that this food is an excellent source of essential omega-3 fats in the form of alpha-linolenic acid, the basic building block to other omega-3s – eicosapentaenoic acid and docosahexaenoic acid. Omega-3, and a proper omega-3 to omega-6 ratio, is important in mental wellness and recovery from psychiatric disorders.

But flaxseed offers more than just the ideal omega-3 source; it contains many polyphenolic compounds such as phenolic acids[1], flavonoids and lignans along with vitamins C and E[2].  One study found that flaxseed significantly decreased chronic stress (cortisol) levels, indicating a possible synergistic effect between omega-3 fatty acid and polyphenols[3].  Other components such as a flaxseed lignan (a phytoestrogen compound called secoisolariciresinol) has been shown to have possible applications in post-menopausal depression[4].

Studies of flaxseed oil supplementation have indicated a good tolerance even in the pediatric population where one study indicated its effectiveness in child bipolar disorder[5].

I recommend a daily intake of one to three tablespoons of ground flax, each tablespoon of which contains about 30 calories, 2.5 grams fat, 2 grams fiber, and 1.5 grams protein[6]. Be sure to grind the flaxseeds as the fine seeds with their hard shell will likely just pass on through the gut otherwise. Flaxseeds can be ground in a coffee bean grinder and the ground powder added to grains, salads, beans – practically any dish for a little texture.

Note that the shelf life of the oily seeds is limited unless kept in an airtight container in the fridge or freezer.  Ground flaxseeds or flax meal should be kept in the freezer; at room temperature and exposed to air, use the ground seeds within one week. Smell the flax – if it has a strong odor such as fishy smell, it may be rancid.  A taste test should reveal a mild nutty flavor – if bitter or sour that also may be a signal that it is rancid.

For these reasons, chia seeds, rich in antioxidants and omega-3 PUFAs may be preferable to some.

References

[1] Oomah, B. D., Kenaschuk, E. O., & Mazza, G. (1995). Phenolic Acids in Flaxseed. J. Agric. Food Chem. Journal of Agricultural and Food Chemistry, 43(8), 2016-2019. doi:10.1021/jf00056a011.

[2] Bidlack, W. W. (1999). Functional Foods: Biochemical and Processing Aspects, G. Mazza, ed. Lancaster, PA: Technomic Publishing Co., Inc., 437 pp, 1998. Journal of the American College of Nutrition, 18(6), 640-641. doi:10.1080/07315724.1999.10718899.

[3] Naveen, S., Siddalingaswamy, M., Singsit, D., & Khanum, F. (2013). Anti-depressive effect of polyphenols and omega-3 fatty acid from pomegranate peel and flax seed in mice exposed to chronic mild stress. Psychiatry Clin Neurosci Psychiatry and Clinical Neurosciences, 67(7), 501-508. doi:10.1111/pcn.12100.

[4] Wang, Y., Xu, Z., Yang, D., Yao, H., Ku, B., Ma, X., . . . Cai, S. (2012). The antidepressant effect of secoisolariciresinol, a lignan-type phytoestrogen constituent of flaxseed, on ovariectomized mice. Journal of Natural Medicines,67(1), 222-227. doi:10.1007/s11418-012-0655-x.

[5] Gracious, B. L., Chirieac, M. C., Costescu, S., Finucane, T. L., Youngstrom, E. A., & Hibbeln, J. R. (2010). Randomized, placebo-controlled trial of flax oil in pediatric bipolar disorder. Bipolar Disorders, 12(2), 142-154. doi:10.1111/j.1399-5618.2010.00799.x.

[6] A very convenient way to have ground flax ready to serve is provided by Carrington Farms Organic Ground Milled Flax Seeds, two tablespoon packets sealed and lasting without refrigeration about one year.

Nutritional yeast for mood, stress, and immune function

 

Nutritional yeast natural source of vitamin B. Saccharomyces cerevisiae.

by R Aiken MD PhD @rcaiken

Nutritional yeast has a nutty, cheesy flavor and is often used to emulate cheese, thicken sauces and dressings, and to provide an additional boost of nutrients, particularly B vitamins, folates, thiamine, riboflavin, niacin, selenium and zinc. It is a complete source of essential amino acids.

Impressive research exists that supports a positive effect of nutritional yeast on stress and related immune function resulting, for example, in a decrease for the susceptibility to the common cold[1]. Beta glucan fiber, found in baker’s, brewer’s and nutritional yeast, helps to maintain our body’s defense against pathogens. And this is extended to improvement in mood states, related to immune vitality and emotional vitality[2].

For endurance athletes who place significant stress on their bodies, regular ingestion of this substance is recommended.

Keep a container of nutritional yeast on your countertop and regularly, even daily, use about one heaping tablespoon (4 grams) on a variety of foods.

References

[1] Auinger, A., Riede, L., Bothe, G., Busch, R., & Gruenwald, J. (2013). Yeast (1,3)-(1,6)-beta-glucan helps to maintain the body’s defence against pathogens: A double-blind, randomized, placebo-controlled, multicentric study in healthy subjects. European Journal of Nutrition, 52(8), 1913-1918. doi:10.1007/s00394-013-0492-z.

[2] Talbott, S. M., & Talbott, J. A. (2012). Baker’s Yeast Beta-Glucan Supplement Reduces Upper Respiratory Symptoms and Improves Mood State in Stressed Women. Journal of the American College of Nutrition, 31(4), 295-300. doi:10.1080/07315724.2012.10720441.

Turmeric for mood, inflammation, and stress

Curry-Turmeric

by R. Aiken MD PhD @rcaiken

Turmeric is a spice with perhaps the highest antioxidant and anti-inflammatory properties of any culinary spice – or herb. One active component of turmeric is curcumin (the pigment responsible for the bright yellow color of the spice), which may have natural antidepressant qualities and has been shown to protect neurons from the damaging effects of chronic stress.

The beneficial effects of curcumin in the pathophysiology of major depression are probably related to its anti-inflammatory and antioxidant properties, inhibition of monoamine oxidase[1], and modulation of neurotrophic factors and hippocampal neurogenesis and neuroplasticity[2].

In a randomized controlled trial[3] , a comparable efficacy was obtained after curcumin monotherapy (1000 mg/day) compared to fluoxetine monotherapy.  Supplementation of conventional antidepressants with curcumin (1000 mg/ day) has shown to be an effective and safe enhancement[4].

Meta-analysis of data from the six clinical trials[5] revealed a significant reduction in major depressive symptoms following the administration of curcumin in combination with piperdine (see below).  These studies all used the 1000 mg/ day and the anti-depressant effect was best after a duration of six weeks.

Turmeric suppresses pain and inflammation similar to non-steroidal anti-inflammatories but without the potential side effects. The health benefits derive, as for Rhodiola and Maca, from “xenohormesis” – a biological principle that explains why environmentally stressed plants produce bioactive compounds that can confer stress resistance and survival benefits to animals that consume them (see Chapter 6).

Turmeric contains about 2% by weight curcumin, so a tablespoon of turmeric (6.8 grams) contains about 136 mg of curcumin. To get 1000 mg/ day curcumin from raw turmeric would then require more than seven tablespoons.  Supplements that purport to contain 500 mg curcumin are commercially available.

One tablespoon of turmeric (1000 mg) per day with a pinch or two of ground pepper (see below) is recommended. If you grate the turmeric root yourself, be prepared to wear gloves as the color is so intense you will have yellow finger tips otherwise.

References

[1] Kulkarni, S. K., Bhutani, M. K., & Bishnoi, M. (2008). Antidepressant activity of curcumin: Involvement of serotonin and dopamine system. Psychopharmacology, 201(3), 435-442. doi:10.1007/s00213-008-1300-y.

[2] Liu, D., Wang, Z., Gao, Z., Xie, K., Zhang, Q., Jiang, H., & Pang, Q. (2014). Effects of curcumin on learning and memory deficits, BDNF, and ERK protein expression in rats exposed to chronic unpredictable stress. Behavioural Brain Research, 271, 116-121. doi:10.1016/ j.bbr.2014.05.068.

[3] Sanmukhani, J., Satodia, V., Trivedi, J., Patel, T., Tiwari, D., Panchal, B., . . . Tripathi, C. B. (2013). Efficacy and Safety of Curcumin in Major Depressive Disorder: A Randomized Controlled Trial. Phytother. Res. Phytotherapy Research, 28(4), 579-585. doi:10.1002/ptr.5025.

[4] Yu, J., Pei, L., Zhang, Y., Wen, Z., & Yang, J. (2015). Chronic Supplementation of Curcumin Enhances the Efficacy of Antidepressants in Major Depressive Disorder. Journal of Clinical Psychopharmacology, 1. doi:10.1097/jcp.0000000000000352.

[5] Al-Karawi, D., Mamoori, D. A., & Tayyar, Y. (2015). The Role of Curcumin Administration in Patients with Major Depressive Disorder: Mini Meta-Analysis of Clinical Trials. Phytother. Res. Phytotherapy Research, 30(2), 175-183. doi:10.1002/ptr.5524.

Ground peppercorns for cognitive function, mood, and bioavailability.

black-ground-pepper

by Aiken MD PhD @rcaiken

Black pepper has an ancient history of being a highly desirable but expensive spice.  It has even been used as a currency.

Piperine is a simple and pungent alkaloid found in the seeds of black pepper. Piperine is commonly known as a bioavailability enhancer for a number of nutraceuticals, including antioxidants[1] and anti-inflammatories[2], as well as for its neuroprotective activity[3]. The Journal of Food and Chemical Toxicology reported that the compound piperine in black pepper increases the cognitive function of the brain and helps mood disorder.

Piperine helps the body absorb curcumin and therefore enhances curcumin’s antidepressant effect long-term. There may be similar absorption assistance given to selenium, vitamin B12, and beta-carotene.

Piperine has shown multiple mechanisms of action, including inhibition of MAO enzymes, elevation of brain serotonin (5-HT) brain derived neurotropic factor (BDNF) levels, and modulation of HPA axis[4].

Because of its intense taste in small quantities, it is typically used as just a few “pinches” into turmeric recipes.

Typically 2.5 mg/ kg is used so for a 70 kg person that would equal 175 mg; a teaspoon of black pepper weighs about 2000 mg, so this is less than 10% of a teaspoon – otherwise known as a “pinch” or two.

References

[1] Johnson, J. J., Nihal, M., Siddiqui, I. A., Scarlett, C. O., Bailey, H. H., Mukhtar, H., & Ahmad, N. (2011). Enhancing the bioavailability of resveratrol by combining it with piperine. Molecular Nutrition & Food Research Mol. Nutr. Food Res., 55(8), 1169-1176. doi:10.1002/mnfr.201100117.

[2] Ying, X., Yu, K., Chen, X., Chen, H., Hong, J., Cheng, S., & Peng, L. (2013). Piperine inhibits LPS induced expression of inflammatory mediators in RAW 264.7 cells. Cellular Immunology, 285(1-2), 49-54. doi:10.1016/j.cellimm.2013.09.001.

[3] Shrivastava, P., Vaibhav, K., Tabassum, R., Khan, A., Ishrat, T., Khan, M. M., . . . Islam, F. (2013). Anti-apoptotic and Anti-inflammatory effect of Piperine on 6-OHDA induced Parkinson’s Rat model. The Journal of Nutritional Biochemistry,24(4), 680-687. doi:10.1016/ j.jnutbio.2012.03.018

[4] Mao, Q.Q., Xian, Y.F., Ip, S.P., and Che, C.T. (2011). Involvement of serotonergic system in the antidepressant-like effect of piperine. Prog. Neuropsychopharmacol. Biol. Psychiatry 35, 1144–1147

Hibiscus for mood, lowering blood pressure, and exercise performance

hibiscus-flower

Flowers of Hibiscus (rosa-sinensis Linn) popularly known as “China-rose flowers” contain significant flavonoids (such as anthocyanin and quercetin) known to have antidepressant activity[1].

The antidepressant effect may be from its antioxidant activity[2]; there are few controlled studies on human populations. Hibiscus has been used in Hawaiian cultures to treat postpartum depression[3].

Another herbal tea, made from the sepals of Hibiscus flowers are beautiful, showy red flowers that are harvested and dried like most teas.  This plant contains bioflavonoids, which are believed to help prevent an increase in LDL cholesterol, and to lower blood pressure[4].  The research is quite clear on these effects. It may work by boosting nitric oxide production, generally an advantage for cardiovascular activities (aerobic exercise).

Again, why bother to make tea with this food and limit the nutrient availability when you can eat it! I use a heaping tablespoon in my morning smoothie. I also like to blend it with green tea and ice, then strain it into water bottles as a drink during exercise.

References

[1] Butterweck, V., Jürgenliemk, G., Nahrstedt, A., & Winterhoff, H. (2000). Flavonoids from Hypericum perforatum Show Antidepressant Activity in the Forced Swimming Test. Planta Medica, 66(1), 3-6. doi:10.1055/s-2000-11119.

[2] Vanzella, C., Bianchetti, P., Sbaraini, S., Vanzin, S. I., Melecchi, M. I., Caramão, E. B., & Siqueira, I. R. (2012). Antidepressant-like effects of methanol extract of Hibiscus tiliaceus flowers in mice. BMC Complementary and Alternative Medicine, 12(1). doi:10.1186/1472-6882-12-41.

[3] Kobayashi, J. (1976). Early Hawaiian Uses of Medicinal Plants in Pregnancy and Childbirth. Journal of Tropical Pediatrics, 22(6), 260-262. doi:10.1093/tropej/22.6.260.

[4] Siddiqui, A., Wani, S., Rajesh, R., & Alagarsamy, V. (2006). Phytochemical and pharmacological investigation of flowers of hibiscus rosasinensis linn. Indian Journal of Pharmaceutical Sciences Indian J Pharm Sci, 68(1), 127. doi:10.4103/0250-474x.22986.