Eating Walnuts and Other Tree Nuts May Lower Cholesterol
In a 2018 meta-analysis and systematic review published in the American Journal of Clinical Nutrition, researcher Marta Guasch-Ferré and colleagues shared their analysis of 26 studies of the effects of diets rich in walnuts on blood lipids and cardiovascular health. The studies included a total of 1059 participants. The walnut-heavy diets were associated with lower total cholesterol, lower LDL (“bad”) cholesterol, and lower triglyceride concentrations. They were also associated with lower apolipoprotein B, a component of LDL.
When walnut-enriched diets were compared to American diets and Western diets, the benefits of the added walnuts on total cholesterol and LDL cholesterol were even more dramatic. The researchers described a Western diet as high in red and processed meats, high-fat dairy products, processed and artificially sweetened foods, and with little intake of fruits, vegetables, fish, legumes, or whole grains.
Compared to control diets, the diets rich in walnuts did not cause weight gain or an increase in body mass index (BMI), and they also did not affect blood pressure.
The studies included in the meta-analysis lasted from four weeks to one year, with a mean length of 8 weeks. The amount of walnuts ranged from 15 to 108 grams per day. In most cases, participants were given whole walnuts to incorporate into whatever daily meal plan they were following, which in some cases was their usual diet and in others was an intervention diet such as a Mediterranean diet or a low-fat diet.
Another meta-analysis published in the American Journal of Clinical Nutrition in 2015 by Liana C. Del Gobbo and colleagues analyzed 61 studies about the effects of tree nuts on cholesterol and related measures, and similarly found that eating tree nuts lowers total cholesterol, LDL cholesterol, ApoB, and triglycerides. Del Gobbo and colleagues wrote, “The major determinant of cholesterol lowering appears to be nut dose rather than nut type.” Tree nuts include walnuts, pistachios, macadamia nuts, pecans, cashews, almonds, hazelnuts, and Brazil nuts.
Vitamin Methyl B12 Improved Autism Symptoms in Randomized, Placebo-Controlled Study
In a 2016 article in the Journal of the American Academy of Child and Adolescent Psychiatry, Robert L. Hendren and colleagues described an 8-week study in which the vitamin methyl B12 improved symptoms of autism spectrum disorders in children.
Fifty-seven children were randomized to receive either 75??g/kg of methyl B12 injected under the skin every three days or saline injections as a placebo instead. Methyl B12 improved the children’s autism symptoms compared to placebo. The improvements correlated with increases in levels of the amino acid methionine in the blood and improvements in cellular methylation capacity. Children with autism spectrum disorders have reduced ability to methylate (i.e. add methyl groups to) DNA. The methylation process helps convert the toxic amino acid homocysteine into beneficial methionine. The children who received methyl B12 showed a reduction in homocysteine and a better ratio of methionine to homocysteine.
Homocysteine is bad for the heart, for cognition, and for fetal development, while methionine can help improve depression and is important to many cellular reactions. Converting homocysteine to methionine requires vitamin B12 and folate, another B vitamin found in foods such as green vegetables and beans.
Taking folate supplements can help make antidepressants more effective by aiding the methylation process. However, some people have a common variation in the MTHFR gene that makes it difficult for the body to make use of folate. These people would need to take the nutritional supplement L-methylfolate instead of regular folate to help in the conversion of homocysteine to s-adenosylmethionine (SAMe, which acts as an antidepressant).
Vitamin D Has More Benefits Than Previously Thought
Vitamin D has long been known as an important vitamin for bone health, preventing conditions such as osteoporosis and rickets. More recently, research suggests that vitamin D may also protect against conditions such as cancer, heart failure, diabetes, respiratory tract infections, and autoimmune disease.
Many Americans have low vitamin D or a vitamin D deficiency. The human body produces vitamin D in large amounts when the skin is exposed to ultraviolet B rays in sunlight. Vitamin D can also be absorbed from vitamin D–fortified foods such as dairy products, some orange juice, and cereals. Some foods such as fatty fish, beef liver, and egg yolks naturally contain some vitamin D, but it is difficult to get enough vitamin D just from consuming these foods.
Low mood or seasonal affective disorder (SAD), in which people feel depressed during winter periods of limited exposure to sunshine, have been linked to low vitamin D.
Other symptoms of low vitamin D vary but can include pain in the joints, bones, or muscles; fatigue; and breathing problems.
Editor’s Note: A few small studies have suggested that 1,500 IU per day of vitamin D supplements can help depressed mood, even in those with normal vitamin D levels. Several studies have indicated that children or adolescents with psychiatric disorders are especially likely to be vitamin D–deficient. Another study found that higher amounts of vitamin D (4,000 IU) could improve cognition in healthy volunteers more than lower doses could. Vitamin D also improved cognition in people with multiple sclerosis and in those with the autoimmune disease Hashimoto’s thyroiditis.
Vitamin D Deficiency in Newborns Linked to Higher Risk of Schizophrenia in Adulthood
A 2018 study by Darryl W. Eyles in the journal Scientific Reports found that newborns with vitamin D deficiency were more likely to develop schizophrenia later in life. The study made use of several Danish data depositories and had a large sample size of 2,602 participants. In this case control study, registries of patients treated for schizophrenia were matched up to preserved dried blood samples collected at their births, and these were compared to other dried blood samples from people without schizophrenia who shared the same sex and birthdate.
The researchers divided participants into quintiles based on vitamin D levels at birth. Compared to those who fell into the fourth quintile, those in the lowest quintile were 44% more likely to be diagnosed with schizophrenia in adulthood. The researchers also determined polygenic risk scores for each participant, that is, they calculated schizophrenia risk based on the presence of various genes. The two processes together explained 1.2% of the variance in schizophrenia diagnoses.
Risk factors for vitamin D deficiency include being born in the winter or spring, living in high-latitude locations, spending early life in an urban setting, and being darker-skinned (especially in high-latitude locations). These risk factors are all correlated with decreased skin absorption of UV rays from the sun, which is how the human body produces vitamin D. The vitamin D receptor is expressed in the brain in areas that are relevant to schizophrenia, such as areas with a lot of dopamine activity, and each of the above risk factors also applies to schizophrenia.
As expected, participants born in the winter and spring had lower vitamin D levels. Participants whose parents had immigrated to Denmark had lower vitamin D than those with parents native to Denmark.
Newborns’ vitamin D levels depend completely on their mothers’ vitamin D levels, so Eyles and colleagues suggest that ensuring pregnant women have adequate vitamin D levels could prevent some cases of schizophrenia.
Adolescents with Bipolar Disorder May Have Higher Levels of Vitamin D–Binding Protein
Vitamin D binding protein. Illustration: Emw [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)]
A 2018 article by Brawnie Petrov and colleagues in the journal Translational Psychiatry suggests that adolescents with bipolar disorder have higher levels of vitamin D–binding protein than adolescents without a mood disorder. The researchers wrote that vitamin D–binding protein “responds early to cellular damage by binding…structural proteins and activating inflammatory cells.”
This pilot study suggests that measuring levels of vitamin D–binding protein could be a useful marker of bipolar disorder. The study was small, with only 12 participants who had bipolar disorder, 11 who had unipolar depression, and 13 with no mood disorder. The researchers hope to follow up with larger studies in adolescents and adults using blood that has already been collected from people with bipolar disorder.
Vitamin D–binding protein is not measured by a standard blood test. The study authors used a technique where they “fished” for inflammatory factors that might be linked to mood disorders. The researchers began by looking for a link between other inflammatory markers in the blood and bipolar disorder, which have repeatedly been found in other studies, but they did not find any such association. There also did not seem to be a link between bipolar illness and vitamin D levels in the blood, only vitamin D–binding protein levels.
It can be especially difficult to distinguish early bipolar disorder from unipolar depression, and if the results of this small study are replicated, a blood test might eventually help to identify people with bipolar disorder earlier.
Meta-Analysis Finds Omega-3 Fatty Acids Do Not Reduce Cardiovascular Disease Risk
In a 2018 meta-analysis published in the journal JAMA Cardiology, researcher Theingi Aung and colleagues found that across 10 studies including a total of 77,197 participants, omega-3 fatty acid supplementation did not reduce risk of coronary heart disease in people at high risk. This newer finding conflicts with a 2017 advisory from the American Heart Association that suggested omega-3 fatty acid supplementation might prevent cardiovascular disease.
When it comes to mood disorders, it has been similarly difficult to pin down whether omega-3 fatty acids are helpful. Data on omega-3 fatty acid supplements for the prevention of depression have been ambiguous, with small numbers of studies and variations in study design that make it difficult to draw strong conclusions about whether these supplements can improve or prevent depression.
A 2016 systematic review by Paola Bozzatello and colleagues in the Journal of Clinical Psychiatry found only seven studies of omega-3 fatty acid supplementation in bipolar disorder. The studies had small sample sizes and widely varying dosage parameters, so the evidence that can be drawn from them is not strong, but the review did find a modest benefit on bipolar depression (but not mania) when omega-3 fatty acids were added to a treatment regimen, compared to treatment as usual.
The same review found that studies of omega-3 fatty acid supplementation in unipolar depression also varied widely, and thus it was difficult to draw inferences from them. Some meta-analyses found no benefit to omega-3 fatty acid supplementation, while others suggested that omega-3s could improve depression. The review found that the type of omega-3 fatty acids used might matter. Supplementation with EPA seemed to improve depression more than supplementation with DHA. The review also cited a 2014 comprehensive meta-analysis by Giuseppe Grosso and colleagues in the journal PLoS One that analyzed the findings from 19 studies in people with depression or depressive symptoms. Grosso and colleagues found that people with more severe depression seemed to benefit more from omega-3s.
