Welcome to the December 2023 issue of Research Extracts. “The Extracts” is designed to keep busy practitioners and savvy consumers up to date on the latest research on diet, nutrients, botanicals, the microbiome, the environment, and lifestyle approaches to good health and wellness. Our medical team, including NDs, MDs, PhDs, RDs, an MS clinical nutrition, an MS biology, and an LAc, summarizes the essence of several interesting recent studies.

In this issue: (1) Mental Health Moment: Peripartum depression and DNA methylation, (2) personalized vitamin D supplementation for athletes, and two that address cognitive support in specific women populations: (3) curcumin for cognitive support during PMS, and (4) zinc for cognitive support in overweight/obesity.

Mental Health Moment: Peripartum Depression and DNA Methylation in Infants

Peripartum depression – depressive thoughts and emotions that occur during and up to one year after pregnancy – affects 15-25 percent of pregnancies. Not only does this affect the mother’s daily life, but it is known to affect fetal brain development and downstream physical, cognitive, and social-emotional functioning in infancy and beyond, although the mechanisms of these effects are lesser known.

The present study uses the U-BIRTH cohort study to examine impacts of peripartum mental health on child outcomes, with consideration of various biological, psychological, and environmental factors at play. Mothers in the study self-reported various lifestyle behaviors, such as diet, sleep, social environments, and quality of life, as well as providing biological samples at birth. The study is following offspring at birth, 18 months, 6 years, and 11 years to measure physical development, sleep, social-emotional skills, and neurological development. Current data is only complete for participants through 18 months.

The results showed that a variety of factors contributed to the incidence of peripartum depression, from genetics to psychosocial factors to delivery experience, and that these factors impacted fetal development and infant behavior. Infants of mothers with lower levels of peripartum depression showed better attention and gaze following behaviors, which were linked to positive social, cognitive, and emotional development over time. The infants of depressed mothers had higher risks of developmental and behavioral concerns. In looking at the newborn blood samples, the researchers also compared infants of depressed mothers on SSRI treatments versus no treatment to infants of healthy mothers to explore DNA methylation differences.

Although peripartum depression and anxiety were associated with differences in DNA methylation in infants, there was no correlation between DNA methylation status and behavior at 18 months. More research targeted to mothers’ mental health and infants’ biological markers, such as DNA methylation, is needed to explore this mechanism and support public health efforts to support maternal mental health and infant outcomes.

Contributed by Carly Duffy, MPH, RD

Reference

For Athletes, Personalized Vitamin D Supplementation is Better than Standardized

Vitamin D status in adults is commonly low or deficient, especially during the winter months when sunlight exposure is lacking. And among athletes, the number with low vitamin D is estimated to be 40-60 percent. In addition, athletes may need higher vitamin D intake due to the physical demands of training and competition, putting them at higher risk for deficiency. Meanwhile, a standardized vitamin D intake recommendation for athletes has not been established. 

In a study of athletes with low serum vitamin D levels, ages 18-50, who exercised at least five hours per week, participants were randomized to no supplementation (control), standardized supplementation (SS), or personalized supplementation (PS) groups. The SS group received 2,000 IU of vitamin D daily for 10 weeks. Vitamin D dosage for the PS group was determined using the following formula to achieve the goal of increasing serum vitamin D to at least 40 ng/dL:

Total loading dose = 40 x (100 – serum vitamin D) x body weight

The total calculated loading dose was then split into daily doses of 4,000 IU. After the number of days had elapsed to achieve the total loading dose, the PS group then received 1,000 IU of vitamin D daily through the remainder of the 10-week trial period. Serum vitamin D was measured at baseline for all groups, during supplementation (5 weeks for the SS and control groups, end of the loading dose period for the PS group), and at completion of the supplementation period (10 weeks from baseline) for all groups.

The PS group achieved higher serum vitamin D levels at the midway measurement than the SS group; however, during the maintenance dose phase (1,000 IU daily) serum vitamin D decreased in the PS group, indicating the 1,000 IU dose was insufficient to maintain vitamin D levels. The SS group experienced a gradual increase in vitamin D throughout the 10-week supplementation period, albeit to a lower extent than the PS group. The authors conclude that personalized supplementation is a better choice for athletes, particularly in the context of low sunlight exposure and increased demands of regular training periods.

Note: Thorne’s at-home Vitamin D Test kit provides health insights by measuring your level of vitamin D and including personalized recommendations based on your vitamin D status and individual health goals.

Contributed by Jennifer L. Greer, ND, MEd

Reference

Curcumin and Cognition in Women with PMS

Symptoms of premenstrual syndrome (PMS) and dysmenorrhea (pelvic pain and uterine cramps during menses) have been correlated with adverse cognitive changes, including forgetfulness, difficulty concentrating, increased distractibility, and difficulty thinking clearly.1

Young women living in university dormitories (n=117; mean age 20) completed a triple-blind, placebo-controlled trial to evaluate the effect of curcumin on cognitive challenges related to menses.2 Participants had been diagnosed by a gynecologist as having moderate-to-intense PMS, using a Premenstrual Syndrome Screening Tool (PSST), and dysmenorrhea, using a visual analogue scale (VAS) to assess pain. Participants were randomized to receive either 500 mg of curcumin (n=57) or a placebo of 500 mg lactose powder (n=60) for 10 days over three menstrual cycles (7 days before and 3 days after onset of menstrual bleeding). 

A food frequency questionnaire was used to analyze dietary intake of micro- and macronutrients to ensure that no significant differences were present between groups. A cognitive abilities questionnaire (CAQ) assessed cognitive function at baseline and at the end of the trial in seven specific areas (memory, inhibitory control and selective attention, decision making, planning, sustained attention, social cognition, and cognitive flexibility), and reported that higher PSST scores correlated with lower cognitive scores at baseline. The CAQ had 30 test items, each evaluated on a five-point scale, with a range of possible total scores from 30 to 150, with higher scores representing better cognitive abilities.

Compared to placebo, those who received curcumin supplementation had statistically significant improvements in their scores for memory, inhibitory control and selective attention, and total cognitive ability task at the end of the study.* Although other measures improved, they were not statistically significant.

Although the impact of pain and discomfort on cognition is not fully understood, this study highlights that curcumin might be beneficial for supporting cognitive function in women who suffer from PMS and dysmenorrhea.*

Note: Thorne’s Curcumin Phytosome delivers 500 mg of curcumin/phospholipid complex per capsule and features the most clinically studied curcumin on the market, with 29-times greater absorption than ordinary curcumin.

Contributed by Carina Toledo, MS Clinical Nutrition, MHI

References

  1. Farage MA, Osborn TW, MacLean AB. Cognitive, sensory, and emotional changes associated with the menstrual cycle: a review. Arch Gynecol Obstet 2008;278(4):299-307. doi:10.1007/s00404-008-0708-2
  2. Bahrami A, Jafari-Nozad AM, Karbasi S, et al. Efficacy of curcumin on cognitive function scores in women with premenstrual syndrome and dysmenorrhea: a triple-blind, placebo-controlled clinical trial. Chin J Integr Med 2023;29(5):387-393. doi:10.1007/s11655-023-3732-3

Zinc for Cognitive Support in Overweight Women

A recent study of 50 centenarians (median age 103) and 73 older adults (ages 80-99; median age 90) found low levels of zinc and chromium in participants’ hair were associated with age-related cognitive decline.1

Knowing that being overweight or obese can impact cognitive function, the researchers for this current study examined the effect of zinc supplementation on cognitive function in overweight or obese women.2 In a double-blinded, controlled trial, 42 women (ages 40-60) were randomized to receive 30 mg of zinc daily or a placebo for 12 weeks. Cognitive function was assessed using Mini-Mental State Examination (MMSE), verbal fluency test, clock drawing test, and Stroop test. Mood (anxiety and depression) were assessed using the Beck Anxiety Inventory and the Beck Depression Inventory-II. Salivary levels of zinc, nitrite, insulin, IL-1β, IL-6, and TNF-α were also assessed.

After 12 weeks, the zinc-supplemented group exhibited significant cognitive improvement on MMSE and Stroop tests compared to the placebo group.* There were no other significant differences on cognitive tests or mood inventories. Although there was no significant difference between zinc and placebo groups regarding body weight, a significant weight reduction occurred within the zinc group by the end of the study. Salivary levels of zinc and IL-1β were both increased in the zinc group, with no other between-group differences in salivary biomarkers noted. The authors note the increase in IL-1β points to the immune-modulating effects of zinc.*

Note: Thorne offers several zinc formulas in both 15-mg and 30-mg capsules. For more insights into reaching your weight management goals, check out Thorne’s Weight Management Test, an at-home health test kit that measures biomarkers associated with blood-sugar metabolism, thyroid and adrenal function, sex hormones, and vitamin D levels – all of which can impact weight.

Contributed by Kathi Head, ND

References

  1. Feng L, Zheng Y, Liu Y, at al. Hair zinc and chromium levels were associated with a reduced likelihood of age-related cognitive decline in centenarians and oldest-old adults. J Nutr Health Aging 2023;27(11):1012-1017. doi: 10.1007/s12603-023-2008-8. 
  2. de Vargas LDS, Jantsch J, Fontoura JR, et al. Effects of zinc supplementation on inflammatory and cognitive parameters in middle-aged women with overweight or obesity. Nutrients 2023;15(20):4396. doi: 10.3390/nu15204396.