Study: Omega 3s may help with anxiety

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

A previous blog post discussed probiotics and anxiety (1), a recent review article examined whether omega-3 fatty acid treatment is associated with an improvement in anxiety (2).

What are omega 3 fatty acids?
• Omega-3 polyunsaturated are dietary fatty acids (PUFAs) that include alpha linoleic acid (ALA) which then converted to eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (3).
• They are nutrients that cannot be made by the human body so we must get them through foods or supplements (3).

What was the study?
The study authors (2) reviewed 19 clinical trials including 2240 participants from 11 countries.

What were the results?

• The authors (2) found an association of improved anxiety symptoms with omega-3 treatment compared with controls groups in both placebo-controlled and non–placebo-controlled trials.
• They also found stronger anti-anxiety effect of omega-3’s when anxiety symptoms were more severe (clinical) than less severe (subclinical) populations (2).

How much omega 3s were used in the studies?

In the review of 19 clinical trials (2), anti-anxiety benefits occurred when using atleast 2grams per day of omega 3s, DHA and EPA combined.

The results did not differ whether the amount of epa was more than or less than 60% of total omega 3s.

What are some caveats?
• The populations studied were broad which makes it difficult to generalize to specific populations like college students.
• Some of the studies had a small sample size.
• There were a broad range of benefits in different studies.
• Omega 3s can interact with medications and supplements.

• Talk to your health provider before considering omega 3’s.

Based on the research findings, not everyone will have the same benefits from omega 3’s.

What are some sources of omega 3s?
According to the National Institute of Health(3), sources of omega 3’s include:
• Fish and other seafood (especially cold-water fatty fish, such as salmon, mackerel, tuna, herring, and sardines)
• Nuts and seeds (such as flaxseed, chia seeds, and walnuts)
• Plant oils (such as flaxseed oil, soybean oil, and canola oil)
• Fortified foods (such as certain brands of eggs, yogurt, juices, milk, soy beverages, and infant formulas)
• Omega-3 dietary supplements include fish oil, krill oil, cod liver oil, and algal oil (a vegetarian source that comes from algae). They come in a wide range of doses and forms.

How much omega 3s do I need per day?
The U.S. Food and Drug Administration recommends consuming no more than 3 g/day of EPA and DHA combined, including up to 2 g/day from dietary supplements (3).

Where can I learn more about omega 3s?

https://ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer/

What are some resources to improve nutrition?
• Nutrition coaching with The OSU Student Wellness Center
• Nutritionist at The OSU Wilce Wilce Student Health center
• Nutritionist at The OSU Wexner medical center
• Nutrition books
• Take a nutrition class
• Take a look at the Dietary Guidelines for Americans.
Harvard’s page on nutritional psychiatry.

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:
1. http://u.osu.edu/emotionalfitness/2016/02/05/study-can-adjusting-gu-bacteria-impact-emotions/
2. Su KP, Tseng PT, Lin PY, et al. Association of Use of Omega-3 Polyunsaturated Fatty Acids With Changes in Severity of Anxiety Symptoms: A Systematic Review and Meta-analysis. JAMA 0Netw Open. 2018;1(5):e182327. Published 2018 Sep 14. doi:10.1001/jamanetworkopen.2018.2327
3. https://ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer/

Strategies for a Successful End of Semester

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

In academics as with many other aspects of life, successful performance requires a series of steps over time that may or may not appear to be connected.

With multiple deadlines,  projects, exams,  etc all due around the same time; the end of the semester can be a high stress time for students.

Luckily there are a series of science-backed strategies that students can apply to be their best physically, mentally, cognitively, and emotionally to maximize chances of academic success.

What health related activities should I INCREASE my chances of academic success at the end of the semester?

Here are 5 things to increase:

  1. Improve your sleep because poor sleep and poor grades go together (with resources to improve sleep):

http://u.osu.edu/emotionalfitness/2017/12/31/poor-sleep-and-poor-grades-might-go-together/

  1. Fruit and vegetable consumption improves mental/emotional well-being:

http://u.osu.edu/emotionalfitness/2015/03/25/fruits-and-vegetables-might-increase-your-odds-of-mental-well-being/

  1. Consider adding these brainpower boosting foods: http://u.osu.edu/emotionalfitness/2015/04/30/food-for-academic-brain-power/
  2. Consider Practicing gratitude exercises to feel better fast: http://u.osu.edu/emotionalfitness/2018/05/31/gratitude-exercises-to-feel-better-fast/
  3. Improve stress management: http://u.osu.edu/emotionalfitness/2017/09/01/dealing-with-too-much-stress/

What health related activities should I DECREASE to improve my chances of academic success at the end of the semester?

Here are 5  things to decrease:

  1. Too much caffeine worsens stress level and brain function:

http://u.osu.edu/emotionalfitness/2017/04/19/study-caffeine-stress-and-brain-function/

  1. Excessive digital media usage can worsen inattention symptoms:

http://u.osu.edu/emotionalfitness/2018/08/30/digital-media-and-inattention-symptoms/

  1. Reduce/avoid alcohol intake because it can impact your academic performance:

http://u.osu.edu/emotionalfitness/2018/02/26/alcohol-and-grades/

http://u.osu.edu/emotionalfitness/2017/06/21/study-alcohol-might-cause-brain-changes/

  1. Cannabis can negatively impact your brain:

http://u.osu.edu/emotionalfitness/2014/11/17/marijuana-4-hidden-costs-to-consider/

  1. Nicotine use can increase depression and anxiety:

http://u.osu.edu/emotionalfitness/2015/04/15/does-smoking-increase-anxiety-and-depression-if-i-quit-will-i-feel-better/

Additional resources if your functioning is limited by your mental health, or if you need additional help:

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

 

Food choices to improve depression

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

A 2017 systematic review of 21 studies  across 10 countries looking at food pattern and depression found that there was an association between food pattern and depression (1).

What food patterns were found to have an DECREASED risk of depression? 

  • The study authors (1) found that high intakes of fruit, vegetables, fish, olive oil, low-fat dairy, antioxidants, and whole grain was associated with a decreased risk of depression (1)
  • Another review found that seafood, vegetables, fruit and nuts based food patterns was associated with a reduced risk of depression. (2)
  • A study of 15,980 adults over 10.8 years found that higher consumption of fruits and nuts, while lower consumption of fast food led to a reduced depression risk (3).

What food patterns were found to have an INCREASED risk of depression? (1)

  • The study authors (1) found that high consumption of red and/or processed meat, refined grains, (added sugars)/sweets, high-fat dairy products, butter, potatoes and high-fat gravy was associated with an increased risk of depression (1).

Are there clinical studies where food pattern was used to TREAT depression? 

Yes. The HELFIMED (4) and SMILES trials (5) used food as a treatment of depressive disorders.

How effective was this?

In both of these trials (4,5), the improvement was almost 50%, which is comparable to some therapies and some antidepressant medications; and benefits lasted for several months afterwards.

What are some caveats?

  • These studies show that nutrition can be helpful to improve depression, but further study is needed.
  • Nutritious food choices DO NOT have to be expensive food choices, and in many cases whole foods can be more affordable than processed foods.
  • For some people, good nutrition is not enough replace counseling or medications, but can be a useful addition.
  • Different people can be healthiest on different styles of eating, depending on a variety of factors.
  • Even with good food choices, it is important to get enough calories; and not engage in restriction or disordered eating behaviors.
    • TDEE calculators and this chart may be helpful in estimating daily calorie needs.
  • Individuals with eating disorders should seek professional assistance via nutritionist, eating disorder specialist, etc. when considering nutritional adjustments.
  • The Food Pantry at OSU is another useful resource.

Any other resources to improve nutrition?

How is your nutrition? What is the quality of your food choices? Are you eating enough or too much food? Are you eating foods that worsen or improve depression?

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Li, Ye & Lv, Mei-Rong & Wei, Yan-Jin & Sun, Ling & Zhang, Ji-Xiang & Zhang, Huai-Guo & Li, Bin. (2017). Dietary patterns and depression risk: A meta-analysis. Psychiatry Research. 253. 10.1016/j.psychres.2017.04.020.
  2.  Martínez-González MA1, Sánchez-Villegas A2. Food patterns and the prevention of depression. Proc Nutr Soc. 2016 May;75(2):139-46. doi: 10.1017/S0029665116000045. Epub 2016 Feb 22.
  3. Fresán, U., Bes-Rastrollo, M., Segovia-Siapco, G. et al. Does the MIND diet decrease depression risk? A comparison with Mediterranean diet in the SUN cohort. Eur J Nutr (2018). https://doi.org/10.1007/s00394-018-1653-x
  4. Natalie Parletta, Dorota Zarnowiecki, Jihyun Cho, Amy Wilson, Svetlana Bogomolova, Anthony Villani, Catherine Itsiopoulos, Theo Niyonsenga, Sarah Blunden, Barbara Meyer, Leonie Segal, Bernhard T. Baune & Kerin O’Dea (2017) A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: A randomized controlled trial (HELFIMED),Nutritional Neuroscience,  DOI: 10.1080/1028415X.2017.1411320 
  5. Jacka FN, O’Neil A, Opie R, et al. A randomised controlled trial of dietary improvement for adults with major depression (the “SMILES” trial). BMC Medicine. 2017;15:23. doi:10.1186/s12916-017-0791-y.