PharmacoNutrition Reviewed

Before going on holiday for the next two weeks, I would like to draw your attention to a recent review entitled “Nutritional Therapies for Mental Health Disorders” published by Lakhan and Vieira online in the Nutrition Journal (21 January 2008).

The authors conclude that “essential vitamins, minerals, and omega-3 fatty acids are often deficient in the general population in America and other developed countries; and are exceptionally deficient in patients suffering from mental disorders. Studies have shown that daily supplements of vital nutrients often effectively reduce patients’ symptoms. Supplements that contain amino acids also reduce symptoms, because they are converted to neurotransmitters that alleviate depression and other mental disorders. Based on emerging scientific evidence, this form of nutritional supplement treatment may be appropriate for controlling major depression, bipolar disorder, schizophrenia and anxiety disorders, eating disorders, attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD), addiction, and autism.”

So far so good.

Although I am a nutritionist by training (and heart), I don’t like the following paragraph of the abstract: “Most antidepressants and other prescription drugs cause severe side effects, which usually discourage patients from taking their medications. Such noncompliant patients who have mental disorders are at a higher risk for committing suicide or being institutionalized. One way for psychiatrists to overcome this noncompliance is to educate themselves about alternative or complementary nutritional treatments.”

Having spent several years in a neuropharmacology lab, I got convinced that it is essential for the patients’ quality of life to take their drugs. Full stop. Admittedly, drugs have side effects; still, current neuropharmacological active compounds are very effective and in the majority of cases cannot be replaced by a dietary intervention. This, however, does not mean that diet might not be useful to

a) support an ongoing drug treatment (i.e. help to reduce the required dose or to ease side-effects) and

b) prevent the onset of some mental disorders in the first place.

So, rather than asking the question of “nutritional therapy vs. drug treatment”, a combined/complimentary approach of classical drugs and dietary intervention might be most effective for patients with mental health disorders. 

If you want to read more about mental health disorders, have a look here: Mental Health Blog

Image taken from: paho.org

In March this year Coca Cola announced in a press release the launch of Diet Coke Plus. This new member of the Coke beverage family will provide the consumer with 15% Daily Value of the vitamins B3, B6 and B12 as well as with 10% Daily Value of zinc and magnesium (calculated per eight-ounce serving).
Well, maybe this offers a great opportunity for a prospective, large scale health trial - considering the 1.4 billion servings Coke sells each day. I just worry somewhat about the data collection………

Out of interest I quickly searched Pubmed and here’s what I found (selection):

Belpoggi F et al.:
Results of long-term carcinogenicity bioassays on Coca-Cola administered to
Sprague-Dawley rats.
Ann N Y Acad Sci. 2006, 1076:736-52

Ladas SD et al.:
Gastric phytobezoars may be treated by nasogastric Coca-Cola lavage.
Eur J Gastroenterol Hepatol. 2002, 14:801-3

Malhotra S et al.:
Effect of an acidic beverage (Coca-Cola) on the pharmacokinetics of carbamazepine in healthy volunteers.
Methods Find Exp Clin Pharmacol. 2002, 24:31-3

Ellertson C:
History and efficacy of emergency contraception: beyond Coca-Cola.
Fam Plann Perspect. 1996, 28:44-8

Image taken from: wikimedia.org

Source: The Journal of Nutrition (2007) 137: 979-984
Article Type: Original Research
Authors: MS Golub, CE Hogrefe, SL Germann

Image taken from:
http://content.answers.com/main/content/wp/en-commons/thumb/f/fe/
180px-Views_of_a_Foetus_in_the_Womb_detail.jpg

Iron deficiency (ID) during pregnancy, especially the third trimester, is common throughout the world. Aside from affecting maternal heath, ID already at moderate levels has been shown to hamper brain development and cognition not only in animal but also human subjects.
In their current paper, Golub et al. report on the impact of iron deprivation during foetal development (third trimester) on behaviour in juvenile rhesus monkeys. Athough ID compromised haematological status, no effect was seen on growth or neurological function at birth (Golub et al., AJCN 2006). However, when animals were reassessed from 6 to 12 months of age, prenatally iron-deprived juveniles had significantly “altered behavioural regulation in learning and memory tasks. (…) In relation to conceptualization of childhood behaviour, they demonstrated lower reactive control, greater impulsivity, reduced harm avoidance, and greater novelty seeking.” As possible explanation, the authors suggest changes in the brain dopamine D2 receptor system, which has been reported to be decreased upon states of prenatal ID.
In light of the above mentioned data, the widespread occurrence of ID and anemia in women of child-bearing age is really unfortunate, and just reminds one that interventions such as supplementation and fortification are obviously still not efficient enough to ensure adequate dietary iron intake in this particularly vulnerable part of the population.