Nutritional Supplements and Mental Health: Here’s What We Know

We’ve all heard that ‘food is good for your mood’. Now, a new study into mental health and nutrient supplementation has taken a leap forward by establishing the gold standard for which nutrients are proven to assist in the management of a range of mental health disorders.

As well as an established relationship between poor diet and mental illness, there is now a vast body of research examining the benefit of nutrient supplementation in people with mental disorders.

To unpack this research, an international team of scientists led by researchers at the University of Manchester and NICM Health Research Institute, Western Sydney University examined the ‘best of the best’ available evidence. The aim was to provide a clear overview of the benefit of specific nutrient supplements – including dosage, target symptoms, safety and tolerability – across different mental disorders. 

The world’s largest review of top-tier evidence, published online yesterday (10th September 2019) in World Psychiatry, examined 33 meta-analyses of randomised control trials (RCTs) and data from 10,951 people with mental health disorders including depression, stress and anxiety disorders, bipolar disorder, personality disorders, schizophrenia and attention-deficit/hyperactivity disorder (ADHD).

Although the majority of nutritional supplements assessed did not significantly improve mental health, the researchers found strong evidence that certain supplements are an effective additional treatment for some mental disorders, supportive of conventional treatment.

All nutrient supplements were found to be safe when recommended dosages and prescriptive instructions were adhered to and there was no evidence of serious adverse effects or contraindications with psychiatric medications.

Summary of results:

  • The strongest evidence was found for omega-3 supplements (a polyunsaturated fatty acid) as an add-on treatment for major depression – reducing symptoms of depression beyond the effects of antidepressants alone.
  • There was some evidence to suggest that omega-3 supplements may also have small benefits for ADHD.
  • There was emerging evidence for the amino acid N-acetylcysteine as a useful adjunctive treatment in mood disorders and schizophrenia.
  • Special types of folate supplements may be effective as add-on treatments for major depression and schizophrenia, however folic acid was ineffective.
  • There was no strong evidence for omega-3 for schizophrenia or other mental health conditions.
  • There is currently a lack of compelling evidence supporting the use of vitamins (such as E, C, or D) and minerals (zinc and magnesium) for any mental disorder.

Lead author of the study, Dr Joseph Firth, Honorary Research Fellow at The University of Manchester and Senior Research Fellow at NICM Health Research Institute, said the findings should be used to produce more evidence-based guidance on the usage of nutrient-based treatments for various mental health conditions.

“While there has been a longstanding interest in the use of nutrient supplements in the treatment of mental illness, the topic is often quite polarising, and surrounded by either over-hyped claims or undue cynicism,” Dr Firth said.

“In this most recent research, we have brought together the data from dozens and dozens of clinical trials conducted all over the world, in over 10,000 individuals treated for mental illness. This mass of data has allowed us to investigate the benefits and safety of various different nutrients for mental health conditions – on a larger scale than what has ever been possible before.” Dr Joseph Firth

​Senior author on the study, NICM Health Research Institute’s Professor Jerome Sarris said as the role of nutrition in mental health is becoming increasingly acknowledged, it was vital that an evidence-based approach be adopted.

“Future research should aim to determine which individuals might benefit most from evidence-based supplements and to better understand the underlying mechanisms so we can adopt a targeted approach to supplement use in mental health treatment.” Professor Sarris said. “The role of the gut microbiome in mental health is a rapidly emerging field of research, however more research is needed into the role of ‘psychobiotics’ in mental health treatment.” 

Explore Further:

To explore pharmaceutical-free options for the promotion of better mental and physical health and peak performance, then please be sure to visit our main website. Our home page, here

About The study and Source material:

The review involved researchers from Western Sydney University, King’s College London, The University of Manchester, The University of Queensland, ORYGEN National Centre of Excellence in Youth Mental Health, The University of Melbourne, University of Toronto and KU Leuven.

The research paper on which this article is based can be accessed in the October issue of World Psychiatry and online at http://doi.org/10.1002/wps.20672

This article is based on material provided to us by the University of Manchester newsroom and appears here with permission.

Looking to Start the School Year on the Right Foot? Get More Sleep!

 By Ryan Meldrum

There is a palpable buzz at the beginning of every school year. There are new classes, new teachers and new friends to be mande. The start of a new school year – not unlike New Year’s Eve – is often accompanied by an optimistic outlook to do better, be better and accomplish more.

As you think about the strategies you might use to achieve these goals, it’s worth considering the merits of getting enough shut-eye.

The old adage of the importance of getting eight hours of sleep at night exists for a reason. Sleep plays a crucial role in washing away the waste that gets built up between our brain cells as a result of all the thinking we do every day.

Sleep helps us transform our short-term memories into long-term ones. Getting a good night’s sleep also makes you more alert, attentive and able to concentrate. Do you see a theme emerging? If you think about the things needed to do well in school, many of them align with the things that a good night’s sleep helps to promote.

But it’s not just in the classroom where sleep will benefit you. Many student-athletes are looking for ways to find that extra edge to outperform their competitors. Why consider more sleep? It aids in muscle recovery, increases reactions times and ensures your immune system is humming on all cylinders. Again, these are things essential to being able to perform at one’s peak abilities.

Don’t take my word for it. Professional athletes like LeBron James, Rafael Nadal, Serena Williams and Cristiano Ronaldo all consider sleep to be a critical part of their regimen for success.

Then there’s the growing body of evidence suggesting that a lack of sleep can increase symptoms of depression, anxiety and irritability. There is also evidence that a lack of sleep decreases self-control. Given the known links between lack of self-control, poor health and problematic behavior, it might come as no surprise that young adults who consistently sleep less than eight hours at night are more likely to be overweight, to engage in risk-taking behaviour (such as texting and driving), to use drugs and to engage in violence.

So, what can you do in order to get more restful, high quality sleep at night and boost your chances of starting the new school year on the right foot?

Stop drinking caffeinated beverages after 3 p.m. Caffeine is a stimulant. It makes it harder for you to fall asleep when you want. While this might seem obvious, what is less widely known is that it takes several hours for caffeine to be fully metabolised by the body. Pulling an all-nighter studying for exams by slamming back energy drinks? You would be better served going to bed at 9 p.m. without any caffeine in your system and waking up at 5 a.m. well-rested and ready to do more studying. Better yet, don’t wait until the night before the exam to start studying

Stop using electronics an hour before going to sleep. If you aren’t familiar with blue light, it’s a wavelength of light that is emitted by TVs, phones, computers and tablets. It suppresses melatonin, which helps our brains to shut down and fall asleep. Of course, if you can’t let go of your phone before bed, you can purchase blue-light blocking glasses on the cheap, and many TVs, computers and phones have settings that can reduce blue light emission (e.g., the “night” mode on smart phone apps like Twitter).

Avoid alcohol. For older students, who think getting a good buzz from alcohol may help you fall sleep more quickly, you should know that the quality of that sleep will not do much with regard to helping you earn better grades. This is because alcohol reduces rapid eye movement (REM) sleep, which helps your brain retain what you have learned during the day.

Explore Further:

To explore pharmaceutical-free options for the promotion of better sleep please see here

For ways to help optimise your learning and academic performance see here 

To explore our complete range of medication-free options to support health, wellbeing and peak performance, then the best starting point is our home page, here

About The Author and Source material:

Ryan Meldrum is associate professor of criminology and criminal justice at the Florida International University. He researches the links between sleep and outcomes ranging from self-control, obesity, substance use, drunk driving and suicidal tendencies. The material for this article was provided to us by the press office of the Florida International University (FIU) on August 26, 2019.  It is reproduced here with permission. The article has undegone minor editiorial amendments to account for British English spelling and our primarily European readership. To visit FIU, see here

Opioids and Chronic Pain: Here’s What the Experts Recommend

By Lesley Colvin and Blair H. Smith

Chronic pain – acute pain that lasts for longer than three months – affects around one in five people in Europe. The increase in use of strong morphine-type drugs (opioids) for the treatment of chronic pain is an area of much concern, particularly in North America.

Termed an “opioid epidemic”, most developed countries have seen a major increase in opioid prescribing over the last decade or so. Our latest research assesses how good the evidence is that opioids can help chronic pain effectively, balanced against any harms they can cause.

One in five Europeans suffers from chronic pain (Photo: Vitoria Santos)

Chronic pain very often doesn’t get better, so people can be prescribed opioids for a long time – years, or even decades. Is there evidence that opioids continue to work well to reduce chronic pain and improve quality of life? The majority of clinical trials only study opioid use for three months, so we don’t really know much about their effectiveness over the longer term. 

One of the few studies that has looked at how effective opioids are after 12 months, found that people who took opioid painkillers were not any more active than those on other types of painkillers.

There is also evidence that long-term use of opioids may be harmful. This is likely to be dose-related as risks increase at higher doses. Known harms include increased risks of:

  • Addiction and misuse: this can affect anyone who is prescribed opioids for pain. Prescribers and patients need to be aware of, and minimise, the risk from the beginning.
  • Overdose and death: deaths from prescription opioids are increasing dramatically in the US for example.
  • Interfering with the endocrine system: changes in hormone levels that can impact on sexual function and fertility.
  • Heart problems: heart attack risk is more than doubled in people taking long-term opioids.
  • Being in a road traffic accident: the risk is higher among drivers taking even relatively low doses of opioids.
  • Worsening pain or “opioid-induced hyperalgesia”: when long-term use makes pain worse. This is often difficult to recognise.
  • Opioid tolerance: when the body becomes used to opioids and requires a bigger dose to get the same painkilling effect.
  • Adverse effects on the immune system: people taking opioids eventually become more prone to infections.

Should we use opioids for chronic pain?

Yes, when appropriate – but with caution. The Scottish Intercollegiate Guideline Network (SIGN) publishes high-quality evidence-based management guidelines. SIGN 136 was the first comprehensive guideline on the management of chronic pain, published in 2013.

As a result of new evidence, SIGN 136 has specifically reviewed the section on opioid use and updated recommendations have recently been published. New research since 2013 has been critically reviewed to ensure that the new recommendations are based on the best available evidence. Some of the key points in the new advice include the following:

  1. Opioids should be used for as short a time as possible, in carefully selected people with chronic pain. This should happen when other treatments haven’t worked to manage the pain and where the benefits outweigh the risks of the serious harms listed above.
  2. Before starting treatment, the person with chronic pain and the prescriber should agree what the treatment aims are. These might include reduced pain, increased activity and/or better quality of life. If this doesn’t happen then there should be an agreed action plan to reduce and stop opioids.
  3. There should be ongoing, regular review by a member of the primary healthcare team, especially if the daily dose is equivalent to more than 50mg of morphine. Review should be frequent in the early stages, and at least annually, after treatment is established. If problems arise – such as opioids no longer providing good pain relief, increasing the dose provides no sustained pain relief or then there is evidence of addiction – then more frequent review will be needed and consideration given to reducing/stopping treatment.
  4. We should always use the lowest effective dose. Higher doses (equivalent to more than 90mg/day of morphine) should only be prescribed alongside review by a pain specialist.

These recommendations are consistent with those of The International Association for the Study of Pain (IASP). The organisation emphasises that the use of other approaches, including behavioural therapies and increasing physical activity to improve quality of life, is preferred.

Where do we go from here?

Current evidence indicates that widespread, long-term opioid prescribing for chronic pain is likely to cause more harm than benefit in society. But some individuals with chronic pain do benefit. They should continue to be prescribed opioids, with the recommended caution, careful monitoring and review, and use of proven non-pharmacological therapies. Some people may also need support to reduce and stop long-term opioids, where the harms outweigh the benefits.

There is an urgent need for research to understand how to manage chronic pain better, including the safe use of and withdrawal from opioids. In tandem we need national policies, based on best available evidence and approaches to educate healthcare professionals and patients. This is likely to require investment in the short term, but it may be a small price to pay for the longer term benefits and probable cost savings of improving chronic pain management, which is the leading cause of disability globally.


Exploring Other Treatment Options

There are a number of proven, non-pharmaceutical options to help manage chronic pain conditions. These not only help to avoid the unwanted side-effects of medication, but some can also help to manage the psychological effects of chronic pain – such as low mood and anxiety – which often accompany the living restrictions which the pain causes.

To explore these treatment options, visit our main website here

About the authors and source material:

The authors of this article are Lesley Colvin, who is Deputy Head of Division – Population Health & Genomics & Chair in Pain Medicine, University of Dundee; and Blair H. Smith, who isProfessor of Population Health Science, University of Dundee

This article was first published in the online academic discussion journal, The Conversation on August 29, 2019 and is reproduced here under CCL copyright provisions. The original article, which includes active links to all references, may be found here

A Wellness Checklist To Help New Students Start College on a Healthy Footing

With A-level results out today, many students will begin preparing to leave home to start their college or university course. For most, this will be the first time that they’ll be on their own – taking sole responsibility for their academics, daily routine and, most importantly, their health.

Taking the reins of their own healthcare will be a novel prospect and one that is easy to neglect, but a few simple preparations can help make this important transition a smooth one.

One expert in helping freshers to settle into their new lives is Bernadette Melnyk, who is chief wellness officer at The Ohio State University. Bernadette advises that “When students step on campus, they really should find out where resources are that they might need – assistance with teaching and learning, the student health centre and mental wellness resources,” and, she adds “Knowing when to ask for help is critical, whether you’re having trouble with your classes or are facing a physical or mental health issue.”

Bernadette urges all new students to check off a few simple but crucial tasks before moving to University and to revisit these throughout the year to so that students can keep happier and healthier when moving out on their own for the first time:

  • Establish Healthy Habits – Just like you schedule your classes, schedule time for physical activity (at least 30 minutes of exercise five times a week), healthy eating, stress relief and at least seven hours of sleep every night. When you map out where your classes are on campus, also find your way to the places that will help you keep those healthy habits like the gym, a dining facility with healthy options and the student health centre.
  • Find Local Health Care – Get connected with a primary care nurse practitioner or physician and the nearest pharmacy. This is especially important for students who come to school with a chronic health condition, but every student could inevitably face a health challenge and should be prepared. Be sure to understand your insurance coverage before accessing care.
  • Make Your Mental Health a Priority – The pressures of school and new surroundings can be nerve-wracking for students. Stress, depression and anxiety are growing mental health challenges among college students. Getting involved in campus organizations helps you to start making friends right away and can go a long way toward reducing stress. If you’re feeling overwhelmed and it’s interfering with functioning, don’t wait to seek professional help.
  • Find a System that Works for You – Whether it’s scheduling workouts and health care appointments in a planner or using apps on your phone to remind you to take medication, find a way to stay organized and proactive about your health and well-being.

Experts say new students should also establish healthy sleep habits and keep all-nighters to a minimum.

Explore more:

To explore the latest developments in educational support technology, designed to promote peak academic performance, please see here. To explore our complete range of medication-free health and wellbeing products, please feel free to visit our home page

About the author and source material:

This article was first published here on 15th August, 2019 and is adapted from an original press release written by Phil Saken, of the Ohio State University News Service. Visit the OSU website here

Five Threats to Heart Health You May Not be Aware of

Many people can recite the major risk factors for heart disease, the stuff of posters, public service ads and dire warnings: smoking, high blood pressure, obesity, diabetes, high cholesterol, lack of exercise.

Effecitve, medication-free options are availble to deal with the effects of Stress and Anxiety and assist with poor Sleep

But what about these? Air pollution, loneliness, lack of green space, lack of sleep and stress.

They’re elements of our lives, often interconnected, that also affect cardiovascular health.

“You can’t control some of these things, so maybe we don’t think about them enough,” said Dr. Amit Khera, director of the Preventive Cardiology Program at UT Southwestern Medical Center in Dallas. “They can directly affect us, but also contribute to some of those major risk factors.”

Take air pollution, for example. Many studies have shown that dirty air is a health hazard, especially for the elderly or people with underlying cardiovascular problems.

“We know that the particulate matter in air when absorbed in the lungs causes inflammation that’s immediately reflected in the cardiovascular system,” said Dr. Donald Lloyd-Jones, chair of the department of preventive medicine at Northwestern University’s Feinberg School of Medicine in Chicago. “That has direct toxic effects.”

In the short term, vulnerable people are urged to stay indoors or wear masks when the air quality is particularly bad. A recent study in Denmark (1)  showed the benefits of exercising outdoors to prevent heart attacks outweighed the risks of air pollution, while a U.S.-based study published in January in the American Heart Association journal Circulation indicated a heart-healthy Mediterranean diet can mitigate some of the damage caused by air pollution.

But in the long term, Khera said, “We need to be aware of air pollution so we can advocate for policies that control it because it affects our health.”

The same is true for green space, which studies suggest is important to heart health because of its connection to physical activity, good eating habits and mental well-being.

“Communities without green spaces may have food deserts (a term for areas without access to fresh, healthy food) and social problems,” Khera said. “If you don’t feel safe, you may be less inclined to do physical activity.

“If people live in a tough environment, you can’t just tell them to move to a new neighborhood,” he said, “People need to be empowered to make communities better.”

Lloyd-Jones said stress and social isolation, which can affect heart health, are hard to measure and define – and to treat.

“There does seem to be an important mind-body connection,” he said. “It’s just hard to know how to intervene effectively. It’s easy to say we should all reduce stress, but obviously it’s hard to do.”

People suffering the psychological effects of stress and loneliness, Lloyd-Jones said, tend to smoke and drink more, have worse eating and sleeping habits, are less physically active and even less likely to take their medication as prescribed.

“All that catalyzes and facilitates the bad things about those other risk factors and amplifies them,” he said. “It becomes a vicious cycle. The social determinants of health fit into the broader picture we’re trying to understand more about.”

Of all peripheral risk factors that may not make the posters and pamphlets, Lloyd-Jones said sleep may be the most significant.

“Good sleep hygiene is incredibly important,” he said. “Lack of sleep or poor sleep drives risk for higher blood pressure, poor eating habits, weight problems and atrial fibrillation (a potentially dangerous irregular heartbeat), especially if you have sleep apnea (interrupted breathing during sleep). Poor sleep hygiene can undermine everything.”

A study published in the Journal of the American College of Cardiology in January found that getting less than six hours of sleep a night was associated with plaque buildup in the arteries, the underlying cause of cardiovascular disease.

In all, the lesser-known risk factors may be harder to gauge than the straightforward numbers for weight, blood pressure and cholesterol. But, Lloyd-Jones said, they form an important part of heart-health assessments for doctors and patients.

“All of these really form such an important context around the physiologic measures we work on with the patient,” he said. “We ignore them at our peril.”

Explore Further:

To explore medication-free options to help manage the effects of stress and anxiety, and to promote better sleep, visit our home page here

Source material:

This article is published here courtesy of the American Heart Association (AHA) media service and was released on 11th July, 2019. You may visit the AHA here