Micronutrients and Mental Health

Kimball et al. (2018) investigated the impact of a nutrition intervention program aimed at optimizing people’s vitamin D levels, on depression and anxiety by collecting data from 16,020 participants. The self-reported health measures of depression and anxiety were evaluated [using European Quality of Life Five Dimensions (EQ-5D) and Targeted Symptoms List (TSL)] as part of a community-based program focused on optimizing overall health through nutritional supplementation, education and lifestyle advice. The EQ-5D revealed that elevated levels of depression and anxiety were reported at baseline by more than 56% of the sample, but 49.2% (n = 7878) of those who reported any degree of depression or anxiety at baseline improved upon the first year in the program. Moreover, 97.2% of the 829 individuals who reported severe or extreme depression at baseline also showed improvements after one year. The better outcomes for depression and anxiety were significantly linked with higher vitamin D status (>100 nmol/L) and more strenuous physical activity, as observed in the regression analyses. This study concludes that those who suffer from mood and anxiety issues may benefit from nutritional supplements. [NPID: micronutrients, nutritional supplements, vitamin D, depression, anxiety]

Since women undertaking multiple roles in today’s society are increasingly experiencing psychological stress, this 2017 systematic review was designed to determine the effects of specific dietary supplements such as essential fatty acids (EFAs), B vitamins, vitamin C, magnesium and/or zinc in managing stress and anxiety in ladies. The search was for studies that recruited women aged 18 or above and that assessed stress and anxiety, including randomized controlled and pseudo-randomized trials. Due to the heterogeneity of the 14 included studies, narrative synthesis was performed. Essential fatty acids were found to be effective in various scenarios: alleviating anxiety in both premenstruation and during menopause in the absence of depression (ineffective after removing depression status); and reducing perceived stress and salivary cortisol levels during pregnancy. Also if disregarding the hormonal phase, EFAs were ineffective in reducing stress or anxiety in four groups of women. When magnesium supplementation was combined with vitamin B6, a reduction in premenstrual anxiety was seen but no effect was found with single supplementations, and when combined or not no impact was observed for stress in women suffering from dysmenorrhea. Other findings included older women experienced anxiety reduction using vitamin B6, but not folate or vitamin B12, while high-dose sustained-release vitamin C reduced anxiety and blood pressure in response to stress. To summarize, EFAs may be effective in reducing prenatal stress and salivary cortisol and may reduce anxiety during premenstrual syndrome and during menopause in the absence of depression; magnesium and vitamin B6 may be effective in combination in reducing premenstrual stress; vitamin B6 alone may reduce anxiety effectively in older women; and high-dose sustained-release vitamin C may reduce anxiety and mitigate increased blood pressure in response to stress. McCabe et al. (2017) called for longer term studies to investigate supplementation and to include compliance testing, use inert substances as controls and reliable outcome measures. [NPID: micronutrients, nutritional supplements, psychological distress, EFAs, essential fatty acids, B vitamins, vitamin C, B6, B12, anxiety, stress, zinc, magnesium, premenstrual anxiety, menstruation, blood pressure, PMS]

Van der Burg and others (2019) conducted this systematic review of nutraceutical clinical trials in mood and psychotic disorders (major depression, bipolar disorder, schizophrenia) in the hope of discovering the most useful nutrient and genetic biomarkers for predicting nutraceutical response in people with these disorders. The team identified 35 studies (totalling 3836 participants) with baseline and endpoint blood nutrient markers and/or genetic polymorphisms. One of the most prominent findings was the strong association between polyunsaturated fatty acid concentrations (mostly EPA and DHA) and psychiatric outcomes observed in 10 out of 11 omega-3 studies, although the exact nature of the correlation varied between studies and diagnoses. No consistent evidence could be determined for levels of other nutrients (including Vitamin D, SAM/SAH ratios, carnitine, folate and vitamin B12) relating to treatment response, nor for the associations between one-carbon cycle genotypes (e.g. MTHFR C677 T, MTR and FOLH1) and treatment response. The available data therefore supported omega-3 indices as biomarkers of response to omega-3 treatments in mood disorders, although the researchers mention that larger population studies examining combinations of polymorphisms are required to determine if any genetic factors influence nutraceutical response in mood and psychotic disorders. [NPID: micronutrients, nutritional supplements, nutraceuticals, major depressive disorder, MDD, depression, bipolar, schizophrenia, genetic polymorphisms, EPA, DHA, vitamin D, SAM, SAH, carnitine, folate, vitamin B12, omega-3s]

This 2019 systematic review and meta-analysis was undertaken to examine and quantify the effects of B vitamin supplementation on mood in both healthy and 'at-risk' populations. The review accumulated 18 articles (2015 participants) including 16 randomized controlled trials involving daily supplementation with 3 or more B group vitamins with an intervention period of at least 4 weeks. Eleven of the 18 articles reported a positive effect for B vitamins over a placebo for overall mood or a facet of mood, while 5 out of the 8 studies in “at-risk” cohorts saw significant improvements in mood. B vitamin supplementation had a positive impact on stress, while it had no effect on anxiety and its beneficial effect on depression did not reach significance level. This review implies B vitamin supplementation can effect positive changes in healthy and at-risk populations for stress, but not for depressive symptoms or anxiety, and suggests its usefulness particularly in people who are at risk due to poor nutrient status or poor mood status. [NPID: micronutrients, nutritional supplements, B vitamins, B12, B6, stress, anxiety, depression]

Nguyen et al. (2019) analyzed the mineral intake (sodium, potassium, calcium, magnesium, phosphorus, iron, zinc, copper and manganese) of 1423 Japanese elderly people (aged 65+) and examined its relationship with depressive symptoms. The mineral intake of the Japanese adults were reported through a validated and brief self-administered diet history questionnaire, while the Geriatric Depression Scale was employed to measure their depressive symptoms. Those subjects with depressive symptoms were found to have taken in less minerals than those without symptoms, considering all minerals except sodium and manganese. Among the males, the level of minerals in the diet did not vary between those showing depressive symptoms and those without signs of depression, but this did not hold true for the females. Mineral intake was significantly lower in female participants with depressive symptoms, compared to those without such symptoms; the minerals potassium, calcium, magnesium, phosphorus, iron, zinc, and copper were significantly and negatively correlated with depressive symptoms among the women, but not men. The results suggested that the deficiencies in mineral intake may be related to depressive symptoms, especially in women, among this Japanese elderly population. [NPID: micronutrients, nutritional supplements, sodium, potassium, calcium, magnesium, phosphorus, iron, zinc, copper, manganese, Japan, depression, women, female]

Wang et al. (2018) reviewed the evidence on the association between the micronutrients zinc, magnesium and selenium, with depression, and also overviewed the potential mechanisms of action behind the interactions. Empirical data seems to strongly suggest the positive association between zinc deficiency with risk of depression, and the inverse dynamic between zinc supplementation and depressive symptoms. Research surrounding the relationship between low magnesium and selenium intake with depression was lacking and inconclusive. The mechanisms of action of these micronutrients could involve the HPA axis, glutamate homeostasis and inflammatory pathways. This review highly regards the importance of consuming adequate servings of micronutrients in supporting good mental health, and provides the readers with the most common dietary sources for zinc and various other micronutrients. The safety and efficacy of supplementation with these micronutrients, used to potentially treat depression, should be investigated more thoroughly, while prospective data on the relationship between micronutrient levels and depression remain desired. [NPID: micronutrients, nutritional supplements, zinc, magnesium, selenium, depression, HPA, HPA axis, glutamate, inflammation]

This 2019 study explored the potential correlation between dietary total antioxidant capacity (DTAC) and nutritional parameters with prevalence of depression among a female sample from Southern Brazil. The Beck Depression Inventory (BDI) helped analyze severity of depressive symptoms, while a 24-hour dietary recall allowed the monitoring of the women’s diet. The DTAC of the population ranged from 435.60 to 4502.62 mg VCE/day and depression was reported in 44% of all participants. Coffee was identified as the most consumed antioxidant food/beverage, while polyphenols were directly linked to the antioxidant capacity of fresh foods. Furthermore, women with depression were found to consume less polyphenols (p=0.022; Cohen's d=0.80), vitamin B6 (p=0.038; Cohen's d=0.65), vitamin A (p=0.044; Cohen's d =0.63), and vitamin C (p=0.050; Cohen's d =0.61). Lower BDI scores were also related with decreased polyphenol intake. This study hopefully provides helpful information on the recommended dietary antioxidant intake to support the prevention of depression among women. [NPID: micronutrients, nutritional supplements, antioxidant, depression, Brazil, coffee, polyphenols, vitamin C, women, female]

This 2017 review summarizes the most valuable current evidence on the roles of zinc, magnesium, copper, lithium, iron, and manganese, and the deficiencies of these micronutrients, in the pathophysiology and treatment of anxiety. [NPID: micronutrients, nutritional supplements, magnesium, copper, lithium, iron, manganese, anxiety]

Rechenberg (2016) describes the lower quality of life, rise in comorbidity and increased mortality associated with depression, and the availability of a treatment option with a better safety profile than the well-established psychotherapy and pharmacotherapy used for clinical depression. Nutritional supplements are proposed as a means of reducing depressive symptoms and can be adopted as adjuvant therapy alongside pre-existing regimens, or as sole therapies. While there has been no shortage of interest in omega-3 fatty acids, B-vitamins (folate, vitamin B12, and vitamin B6), S-adenosylmethionine (SAMe), 5-hydroxytryptophan (5-HTP), and magnesium in the management of depression, this article explores the clinical data on these nutritional interventions and reviews its relevance to the pathophysiology and epidemiology of clinical depression. [NPID: micronutrients, nutritional supplements, copper, selenium, manganese, iodine, vanadium, depression, anxiety, enzymes]

As matcha tea gains popularity and has been found to contain higher amounts of green tea phytochemicals compared to regular green tea, this 2017 review focuses on the tea constituents caffeine, L-theanine, and epigallocatechin gallate (EGCG) and its widely reported beneficial impact on mood and cognitive performance. This review aimed to summarize the acute psychoactive effects of these tea components by evaluating 49 human intervention studies. Since a limited number of intervention studies on EGCG was discovered its effects were inconclusive. But enhanced alertness, arousal and vigor were reported with caffeine, as well as better performance on time-consuming and demanding cognitive tasks, even at doses as low as 40mg. Caffeine in combination with L-theanine especially increased alertness and raised performance levels in attention-switching tasks, but to a lesser extent than caffeine alone. Even L-theanine alone, starting at 200mg, improved relaxation, tension, and calmness. These studies demonstrate the positive influences of L-theanine and caffeine on avoiding distractions and maintaining attention and memory, and the relaxing effect of L-theanine (through reduction of caffeine-induced arousal). [NPID: micronutrients, nutritional supplements, green tea, phytochemicals, caffeine, L-theanine, and epigallocatechin gallate (EGCG), cognitive performance, alertness, arousal, vigor, relaxation, tensin, calmness, attention, memory]

This 2019 paper studied the relationship between frequency and duration of drinking tea with depressive symptoms among a set of Chinese seniors, assessing whether the interaction varies by gender or age. The data used was from 2005, 2008/2009, 2011/2012 and 2014 waves of Chinese Longitudinal Healthy Longevity Survey (CLHLS). There was a correlation between consistent and frequent tea drinking with significantly fewer prevalence of depressive symptoms, while socioeconomic status, health-related behavior, physical health, cognitive function, and social engagement mediated this relationship. Although this association was only significant for males and the oldest groups, and not among women or younger elders, these findings support the consistent and frequent tea-drinking may effectively reduce the Chinese elderly population’s chances of developing depressive symptoms. In China, continuing the tradition of drinking tea may promote healthy aging in a cost-effective way. [NPID: micronutrients, nutritional supplements, tea, China, elderly, depression, socioeconomic status, cognitive function]

Palmitoylethanolamide (PEA), known for its metabolic and neuroprotective effects, was investigated here by Lama et al. (2020) on its impact on the monoamine system and synaptic plasticity. In this preclinical study C57Bl/6J male mice were fed high-fat diet (HFD) for 12 weeks, before continuing in this trial being fed either 30 mg·kg-1 daily of ultra-micronized PEA or vehicle (control) for 7 weeks alongside a HFD. The study documented the depressive- and anhedonic-like behaviour, and cognitive performances of the mice, as well as performed monoamine analyses on the nucleus accumbens (Nac), prefrontal cortex (PFC), and hippocampus, and checked markers of synaptic plasticity and neurogenesis. The results showed few depressive- and anhedonic-like behaviour and reduced cognitive deficit induced by the HFD in the PEA-fed mice. Those given PEA also exhibited higher levels of 5-HT in the PFC, less dopamine and 5-HT replacement in the Nac and PFC, respectively, while their dopamine concentrations in the hippocampus and PFC also increased. Moreover, PEA seemed to improve synaptic plasticity, by restoring brain-derived neurotrophic factor signalling pathways in the hippocampus and PFC. The researchers highlighted PEA’s ability to promote neurogenesis, indicated by the reversal of the reduced glutamatergic synaptic density induced by HFD in the stratum radiatum of the CA1 of the hippocampus. PEA’s influence in monoamine homeostasis, synaptic plasticity and neurogenesis are evident, which imply its potential as an adjuvant therapy for suppressing depression-like behavior and reducing memory deficit. [NPID: micronutrients, nutritional supplements, PEA, Palmitoylethanolamide, monoamine system, synaptic plasticity, animal, cognition, depression, neurogenesis, anhedonia, nucleus accumbens, prefrontal cortex, hippocampus, memory]

Since the association between low vitamin B6 levels and increased risk of depression has been documented but mostly in non-Hispanic white populations, Arévalo et al. (2019) recruited older adults of Puerto Rican descent, a population that has been previously reported to possess higher susceptibility to develop symptoms of depression, and tested the relationship between vitamin B6 status and depressive symptomatology longitudinally, at 3 different stages over ~ 5–7 years (baseline, after 2 years, and after 5 years). The participants’ plasma concentrations of pyridoxyl-5’-phosphate (PLP), which is a time-varying predictor of vitamin B6 levels, was determined to be significantly associated with depressive symptomatology. The data showed higher prevalence of depressive symptoms in the subjects deficient in PLP compared with those with highest levels, at baseline and over time also, even after controlling for multiple factors (age, sex, education, BMI, smoking and alcohol use, nutrition, perceived stress, stressful life events, allostatic load, use of antidepressants). But PLP levels were not linked with the rate of change in depressive symptomatology over time. The identification and treatment of people with vitamin B6 deficiency may be an effective preventative approach particularly among those of Puerto Rican descent since suboptimal concentrations of PLP was linked with higher depressive symptomatology among this study population and this relationship continued over time. [NPID: micronutrients, nutritional supplements, depression, Puerto Rico, vitamin B6, pyridoxyl-5’-phosphate, stress, allostatic load]

While levels of magnesium are believed to be lower in patients with mental disorders, especially depression, this 2020 systematic review aimed to analyze the literature from 2010 to March of 2020 regarding the micronutrient in psychiatric disorders, in order to determine magnesium’s relationship with psychiatric pathology and its effectiveness as a therapeutic supplement. Thirty-two relevant articles were identified, consisting of 18 Depressive Disorders (DD), 4 Anxiety Disorders (AD), 4 Attention Deficit Hyperactivity Disorder (ADHD), 3 Autism Spectrum Disorder (ASD), 1 Obsessive–Compulsive Disorder (OCD), 1 Schizophrenia (SCZ) and 1 Eating Disorders (ED). Botturi et al. (2020) mainly found positive results with respect to depressive symptoms in 12 studies, with 7 indicating a significant association between lower serum magnesium levels and depression (measured with psychometric scales), 2 papers showing better depression-related outcomes following magnesium intake, and another 2 demonstrating the improvement of depressive symptoms in participants taking magnesium as an adjuvant treatment with antidepressants, all compared with control. Moreover, 2 more papers reported an association between low magnesium concentration with ADHD, while 2 other papers reported correlations of higher magnesium levels with lower Hamilton Anxiety Rating Scale (HAM-A) scores among depressed individuals and discovered the ideal levels in stressed patients. Magnesium was not significantly connected with panic or Generalized Anxiety Disorder (GAD), associations with ED and SCZ were inconsistent, and only one of three papers found lower levels in ASD. This review judges magnesium supplementation as having beneficial and potentially therapeutic effects, and believes there is reason to demand clinical trials investigating the efficacy of magnesium as single or adjuvant therapy to confirm its appropriate clinical use. [NPID: micronutrients, nutritional supplements, magnesium, mental disorders, depression, autism, ASD, ADHD, OCD, schizophrenia, SCZ, eating disorders]

The aim of this 2018 study was to evaluate the differences between 247 patients with major depressive disorder (MDD) and 248 healthy individuals (matched by age and sex) in their serum levels of the macro-minerals (MM) calcium and magnesium, and of the trace elements (TE) copper, iron, manganese, selenium, and zinc. Another objective was to assess the prevalence of depression associated with these MMs and TEs [both analyzed by atomic absorption spectroscopy (AAS)]. The data indicated significantly higher concentrations of copper and lower levels of calcium and magnesium, iron, manganese, selenium, and zinc in MDD patients compared with control subjects (both p-values  < 0.05). A disturbance in the element homeostasis was strongly suspected, possibly signifying that abnormal serum concentrations of MM and TE may contribute substantially to the pathogenesis of MDD and that measuring of these elements and minerals may be an effective tool for depression risk prognosis. [NPID: micronutrients, nutritional supplements, MDD, major depressive disorder, depression, calcium, magnesium, macro-minerals, copper, iron, manganese, selenium, zinc]

The aim of this 2020 study was to investigate the correlation between serum vitamin D concentrations and specific domains of depressive symptoms by each sex in the Korean general population. Rhee, Lee, and Ahn (2020) retrieved data from the Korea National Health and Nutrition Examination Survey of 2014 to gather their sample size of 820 men and 916 women (aged 19-76) who had completed health interviews and health examinations. These examinations provided data for serum 25-hydroxyvitamin [25(OH)D] concentrations, the Patient Health Questionnaire-9 (PHQ-9), and certain covariates. A statistically significant association between log-transformed serum 25(OH)D concentrations and total PHQ-9 scores in men (incidence rate ratio [IRR] = 0.74) was identified after multiple covariate adjustments. In men, log-transformed serum 25(OH)D concentrations were significantly associated with the PHQ-9 cognitive/affective subscore (IRR = 0.56). The findings show that serum vitamin D levels were inversely associated with cognitive/affective depressive symptoms in men. [NPID: micronutrients, nutritional supplements, vitamin D, Korea, cognition, affect, depression]

In German.

This 2010 trial investigated the effects of a high-dose B-complex vitamin and mineral supplement (Berocca) on the cognition and mood of adult men (aged 30-55) in full-time employment. Few studies have examined the influential role of vitamins and minerals on psychological functioning in healthy non-elderly adults, although much of the general population take vitamins and minerals as dietary supplements with the goal of ameliorating stress and fatigue and enhancing mental functioning. In this present article, supplementation with vitamins or minerals resulted in significant improvements in perceived stress levels, answers to the General Health Questionnaire, and in the ‘vigor’ subscale of the mood assessment called Profile of Mood States (POMS). Moreover, the group that received vitamin/mineral supplements performed better in the Serial 3’s subtractions task (a test of mental health) compared with the control group. The intervention group also reported being less “mentally tired” both before and after completing the cognitive demand battery. The study found that healthy adults may benefit from taking vitamins/minerals, as supplementation led to less stress, better mental health, higher vigor, and enhanced cognitive performance while performing intense mental tasks. [NPID: cognitive, cognition, vigor, stress, health, vitamins, minerals, vitamin C, vitamin B, mood, supplements, supplementation, fatigue]

This 2013 meta-analysis reviewed the literature on the influence of diet supplementation on mood in people without any disease symptoms. It is thought that since mood can be affected by the biochemical processes that occur in the brain, even a minor dietary inadequacy can lead to a small change in enzyme efficiency, and ultimately affect the person’s mood state. Additionally, supplementation is expected to improve mood when the diet does not provide optimal amounts of micronutrients. This review searched for studies that investigated the impact of multivitamin/mineral supplements for at least 28 days, while considering the mood, stress, and mild psychiatric symptoms of the participants (the general population). The research also had to be randomized and placebo-controlled to be included. Ultimately 8 studies met the inclusion criteria, and the meta-analysis revealed that supplementation significantly reduced the levels of perceived stress, mild psychiatric symptoms, and anxiety in the subjects. Reduced fatigue and confusion were also observed in the participants, but there was no reduction in cases of depression. Nevertheless, micronutrient supplementation had positive effects on perceived stress, mild psychiatric symptoms, and aspects of everyday mood in healthy adults with no disease symptoms. It should be added that supplements containing high doses of B vitamins may be more effective in improving mood states. Areas that require further investigation include the optimal levels of micronutrient consumption, optimal doses, and the most appropriate active ingredients. [NPID: supplements, supplementation, mood, depression, stress, anxiety, fatigue, tired, confusion, micronutrients, nutrients, vitamins, B vitamins]

Although taking vitamin supplements have shown ability to alleviate symptoms of mood dysfunction, this 2016 study highlights that healthy older women have rarely been included in these experiments. This present study looked at the effects of multivitamin supplementation for 4 weeks on mood in 76 healthy women aged 50-75 years. Each participant was then assessed on their current mood state and experience of mood over the previous week or longer. Also, mobile phones were used to assess changes in real-time mood ratings twice a week in the home. Although there was no evidence indicating that multivitamins confer benefits using measures of current mood and reflections of recent mood while in the laboratory, the mood assessments conducted at home several hours post-dose demonstrated lower ratings of stress in the multivitamin group. Moreover, it appeared that multivitamins reduce mental fatigue according to the results of these tests taken at home. Overall, we learned that over the 4 weeks of multivitamin supplementation, the subtle swings in stress levels produced by these supplements may not be noticed when examining the pre- and posttreatment mood only. It may be the case that mobile phone-based assessments conducted at home are more sensitive to the influence of nutritional interventions compared with traditional examinations undertaken in the laboratory. [NPID: supplements, supplementation, vitamins, multivitamins, mood, women, older women, nutrition, diet]

Since research studies have increasingly focused its attention on inflammation and oxidative stress to form explanations on the development and maintenance of bipolar disorders, this 2019 study planned to test the effect of coenzyme Q10 on blood levels of inflammatory and oxidative stress biomarkers in patients with bipolar disorder during their depressive phase. The participants with bipolar disorder were randomly chosen to either receive 200 milligrams of the coenzyme Q10 or a placebo daily. While there were 89 subjects at the start of the trial, 69 people completed the entire 8-week study. There was evidence of increased oxidative stress markers and fewer inflammatory biomarkers in the coenzyme Q10 group as time passed and compared with the placebo group. The total antioxidant capacity and level of total thiol groups increased, while tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), nitric oxide, and interleukin-10 (IL-10) dropped. To sum it up, the coenzyme Q10 favorably influenced oxidative stress and inflammatory biomarkers in patients with bipolar disorder during the depressive episode. This adjuvant treatment may represent a safe and effective strategy for treatment of patients with bipolar disorder during the depressive phase. [NPID: bipolar disorder, inflammation, oxidative stress, stress, oxidation, coenzyme Q10, CoQ10, depressive]

Following the devastating flooding in South Alberta in 2013, residents were invited to take part in this 2015 study investigating the beneficial impact of nutrient supplements after a natural disaster. The researchers wanted to replicate a previous randomized trial conducted in New Zealand that showed multinutrients’ positive effects on mental health after the 2010-11 earthquakes. In Alberta, 56 adults (aged between 23 and 66) were randomized to either receive vitamin D alone, a multivitamin formula (B-complex), or a broad-spectrum mineral/vitamin formula. Although substantial reductions in depression, anxiety and stress were observed in all 3 groups, the B-complex and broad-spectrum mineral/vitamin groups demonstrated significantly greater improvements in stress and anxiety than the vitamin D group. There was no difference to note between the individuals who received the B-complex formula and those who took the broad-spectrum mineral/vitamin formulation. This study becomes the third study to support the use of nutrient formulas with various minerals and vitamins to minimize stress associated with natural disasters. Even still, additional research is encouraged to determine the potential population benefit of distributing these treatments as a post-disaster public health measure. [NPID: natural disasters, New Zealand, Alberta, Canada, depression, anxiety, stress, nutrients, micronutrients, vitamins, multivitamins, minerals]

The aim of this 2020 study was to evaluate the effect of selenium deficiency on depressive disorders among a sample of adults. There were 9354 participants recruited by the Polish-Norwegian Study (PONS) cohort, including only men and women aged between 45-65. The average intake of selenium and other nutrients were analyzed against depressive disorders, while also considering possible confounders such as presence of chronic diseases, life problems, pain levels, physical activity, and income. Low selenium, as well as high lipids intake and low iron consumption appeared to significantly affect depressive disorders. There were also non-dietary risk factors that showed strong correlations with depression, including home stress, pain, and low income. Pain was found to mediate a small part of the effect of morbidity too. Furthermore, depressive disorders are associated with work problems and low physical activity. In this analysis model, the effect of dietary risk factors on depressive disorders was moderate compared to non-dietary variables. Among the dietary factors investigated, selenium consumption showed the strongest connection with depression. [NPID: depression, selenium, vitamins, minerals, multi-nutrients, nutrients, nutrition, Polish, Poland, pain, physical activity, income, lipids, iron, stress, income]

This 2018 study was the first randomized trial to measure the influence of combined magnesium and vitamin B6 supplementation on stress in a stressed population with low levels of magnesium. The sample included healthy adults with a serum magnesium concentration within a low range (0.45 mmol/L-0.85 mmol/L), and who scored greater than 18 in the stress subscale of the Depression Anxiety Stress Scales (DASS-42). The participants were firstly randomized to either receive the magnesium-vitamin B6 combination (containing 300mg of magnesium and 30mg of vitamin b6) daily or the 300mg of magnesium alone. The stress subscale score significantly reduced from baseline to Week 8 in both treatment groups. There was no notable difference in stress scores between the magnesium-vitamin B6 combination group and the magnesium group. Further data analysis revealed that individuals with severe or extremely severe stress showed a 24% greater improvement after taking the magnesium-B6 combination for 8 weeks versus magnesium alone. Adverse effects were reported in 12.1% of the combination therapy group and in 17.4% of the monotherapy group. Overall, the data demonstrated that magnesium supplements reduced stress levels in healthy adults with low magnesium, although the combined formula of magnesium and vitamin B6 was not apparently superior to the magnesium alone. The dual therapy did show better results versus magnesium monotherapy among people with severe and extremely severe stress. [NPID: magnesium, vitamin B6, pyridoxine, stress, supplement, supplementation, health, diet, nutrition, nutrients, micronutrients, vitamins, minerals, multivitamins]