The potential of Vitamin B1 in improving depression in the elderly

Depression is one of the most common psychiatric disorders among the elderly. Thiamine (Vitamin B1) has been hypothesised to play an important role in mental health. Inadequate Vitamin B1 intake and Vitamin B1 deficiencies may lead to physical and mental health issues. For example, thiamine diphosphate, the most bioactive form of Vitamin B1, is a coenzyme in glucose metabolism crucial for the secretion and metabolism of serotonin. It plays an important role in nerve conduction. In the elderly, Vitamin B1 deficiency is common and could induce mitochondrial dysfunction and chronic oxidative stress, which may contribute to depression. Oxidative stress due to Vitamin B1 deficiency may be linked to neuronal damage and decreased hippocampal volume in patients with major depression Additionally, a deficiency in Vitamin B1 may lead to irreversible neurological consequences such as Wernicke’s encephalopathy and peripheral neuropathy.

This study found a relatively high prevalence of subclinical Vitamin B1 in older Chinese adults. After adjustment for age, sex, city, and residence, lower concentrations of free thiamine, thiamine monophosphate, or thiamine diphosphate were associated with higher odds of being depressed (all P-trend < 0.01). The results of this study suggests an association between thiamine malnutrition and depressive symptoms among older Chinese adults.

Zhang G et al. Thiamine Nutritional Status and Depressive Symptoms Are Inversely Associated among Older Chinese Adults. J Nutr. 2013 Jan; 143(1): 53–58.

National Nutrition Week

Vegetables are awesome!

Each year National Nutrition Week raises awareness around the role of food on our health, and supports the community to enjoy healthy eating. This year we are encouraging families to find more ways to enjoy vegetables, and to eat one extra serve of vegetables every day.

#NNW2017 #nationalnutritionweek#nutrition #wellness #fitness  #nutritionist #foodie #health #lifestyle #foodasmedicine

Some blueberries per day…

Are blueberries the superfood we are looking for? Well, as we know, blueberries have been used as “food as medicine” for a very long time. Blueberries have a wide spectrum nutritional profile and have antioxidant and anti-inflammatory properties. The increased consumption of berries has been shown to improve cognitive function and reduce the risk of cardiovascular disease. There are concerns regarding the ability to greatly increase and maintain an individual’s daily fruit and vegetable consumption over a long-term period (particularly to the nutritional guidelines of 5 servings of vegetables and 2 servings of fruit per day). The role of dietary supplementation with bioactive components, such as those in blueberries, is a tasty and feasible dietary intervention to improve health.

In this study by Stull and colleagues, participants were randomised to consume either a smoothie containing 22.5 g blueberry bioactives (blueberry group, n = 15) or a smoothie of equal nutritional value without added blueberry bioactives (placebo group, n = 17) twice daily for 6 weeks. There was a total of 1462 mg of total phenolics, 668 mg of anthocyanins per day. The blueberry and placebo smoothies were identical in physical appearance and macronutrient content apart from the addition of the blueberry bioactives to the blueberry smoothie.

Daily dietary supplementation with whole blueberries improved insulin sensitivity in obese, nondiabetic, and insulin-resistant participants. The mean change in insulin sensitivity was improved significantly more in the blueberry group compared to the placebo group. The percent change in insulin sensitivity was greater in the blueberry group (22.2 ± 5.8%) compared to the placebo group (4.9 ± 4.5%) (P = 0.02). Insulin sensitivity was enhanced in the blueberry group at the end of the study.

Consumption of smoothies (in the case of this study with blueberries) may be an attractive and convenient dietary approach for adults and children who do not consume the recommended daily amounts of fruits and vegetables. However, the daily consumption of fruit and vegetables should always be promoted.


Stull AJ et al. Bioactives in Blueberries Improve Insulin Sensitivity in Obese, Insulin-Resistant Men and Women. J Nutr. 2010 Oct; 140(10): 1764-1768.

Herbal medicine use and anxiety

Anxiety disorders are the most prevalent mental health condition in Australia. Over a quarter of Australian adults have reported having an anxiety disorder diagnosis in their lifetime. Approximately 14.4 % had a diagnosis of an anxiety disorder in the previous 12 months. Herbal medicines are being used by adults with anxiety and are commonly self-prescribed for anxiety symptoms.

There were 400 participants in this Australian study (203 males (50.8 %) and 197 females (49.3 %)). The mean age was 49.1 years (range 18 to 85 years). The majority of participants in this study (82.3 %) experienced anxiety symptoms in the previous 12 months, with 47 % reporting having previously been diagnosed with an anxiety disorder. In addition, 72.8 % of participants had used herbal medicines specifically for anxiety symptoms in their lifetime, while 55.3 % had used prescribed pharmaceuticals. 27.5 % of participants had used herbal medicines concurrently with prescribed pharmaceuticals. Of those with an anxiety disorder diagnosis (n = 188), 83.5 % used herbal medicines for anxiety symptoms, which compared to 63.2 % of those without a disorder diagnosis (n = 134). The most commonly used herbal medicine to treat anxiety symptoms in the previous 12 months was chamomile (43 %), followed by lavender (32.5 %).

Herbal medicines are being used by adults with anxiety and are commonly self-prescribed for anxiety symptoms. The authors noted that health practitioners who are experts in herbal medicine prescribing were infrequently consulted.


McIntyre E, Saliba AJ, Wiener KK, and Sarris J. Herbal medicine use behaviour in Australian adults who experien AJce anxiety: a descriptive study. BMC Complement Altern Med. 2016; 16: 60.

Mindfulness meditation for anxiety relief

Anxiety is the cognitive state related to the inability to control emotional responses to perceived threats. Anxiety is inversely related to brain activity associated with the cognitive regulation of emotions. Mindfulness meditation has been found to regulate anxiety.

Mindfulness meditation is premised on stabilising attention, acknowledging discursive sensory events as ‘momentary’ and ‘releasing’ them without affective reaction. Training in mindfulness meditation has been found to significantly reduce anxiety in clinical and experimental settings. Mindfulness meditation is hypothesised to regulate emotions by modifying cognitive and affective evaluations to sensory events by cognitive reappraisal processes. Long-term training in mindfulness meditation has been found to improve cognitive processes that subsequently improve a wide spectrum of health outcomes.

In this study, 20 minutes of mindfulness meditation significantly reduced state anxiety in each session that meditation was practiced. Anxiety was found to be inversely related to activity in a brain network involved in cognitive and affective control. Meditation-related anxiety relief was associated with greater activity in a distinct network of brain regions involved in cognitive reappraisal processes.


Zeidan F et al. Neural correlates of mindfulness meditation-related anxiety relief. Soc Cogn Affect Neurosci. 2014 Jun; 9(6): 751–759.

Chocolate and the Heart

Chocolate and the Heart ❤️

Consuming moderate amounts of chocolate has been associated with significantly lower risk of being diagnosed with atrial fibrillation – a common and dangerous type of irregular heartbeat. These findings were from a large study of 55,502 men and women (26,400 men and 29,102 women) in Denmark led by researchers at the Harvard T.H. Chan School of Public Health and in Denmark. Median follow-up was 13.5 years.

Compared with those who ate a 28 g (1 ounce) serving of chocolate less than once per month:

  • men and women who ate one to three servings per month had a 10% lower rate of atrial fibrillation
  • those who ate one serving per week had a 17% lower rate of atrial fibrillation
  • those who ate two to six servings per week had a 20% lower rate of atrial fibrillation.
  • Results were similar for men and women.

Accumulating evidence indicates that moderate chocolate intake may be inversely associated with atrial fibrillation risk.

Chocolate is awesome!

Mostofsky E et al. Chocolate intake and risk of clinically apparent atrial fibrillation: the Danish Diet, Cancer, and Health Study. Heart. 2017 May 23. pii: heartjnl-2016-310357. doi: 10.1136/heartjnl-2016-310357. ( )

Dark chocolate

Fruit and vegetable consumption may help reduce the prevalence of psychological distress

Mental disorders affect 10% of the world population and represent 30% of non-fatal global burden of disease. Depression is a leading cause of disability worldwide and is projected to rank among the three leading causes of global disease burden by 2030. Depression in later life is associated with increased morbidity and mortality, and decreased physical, cognitive and social functioning.

Evidence suggests a link between diet and mental health, such as depression. Several large cross-sectional studies have shown that greater consumption of fruit and vegetables has been associated with better mental health, including lower odds of depression and psychological distress, in the general population. Higher consumption of fruit and/or vegetables has been associated with lower odds of incident depression in middle-aged Australian women followed over 6 years.

Fruit and vegetable consumption may help reduce the prevalence of psychological distress among middle-aged and older adults. Fruit and vegetables are rich in micronutrients (vitamins and minerals) and phytochemicals that may help reduce oxidative stress and inflammation. Oxidative stress and inflammation can have detrimental effects on mental health. Nutrients can reduce oxidative stress and inflammation. For example, antioxidants such as vitamins C, E and polyphenols may help reduce oxidative stress while magnesium has been associated with lower levels of C reactive protein, a marker of low-grade inflammation. Deficiencies in B vitamins (e.g. vitamin B12 and folic acid) have been associated with depression.

This study found that fruit and vegetables were more protective for women than men, suggesting that women may be more responsive to the health effects of fruit and vegetables.

Nguyen B, Ding D, Mihrshahi S. Fruit and vegetable consumption and psychological distress: cross-sectional and longitudinal analyses based on a large Australian sample. BMJ Open. 2017 Mar 15;7(3):e014201.

Depression and serum 25-hydroxyvitamin D in older adults living at northern latitudes

Depression is one of the most common mental disorders and is recognised as a major contributor to the global burden of disease. Depressive symptoms are prevalent in approximately 15% of community-dwelling older persons, with major depressive disorder prevalent in 1-5% of adults 65 years and older. Depression risk among older adults may be further exacerbated by an interaction of factors beyond age such as poor dietary intake and time spent indoors which can negatively affect vitamin D status.

Men and women with a deficiency of vitamin D had more depressive symptoms versus adequate vitamin D status. Furthermore, men with a deficiency of vitamin D were more likely to have current major depressive disorder compared with men with adequate vitamin D status.

The authors noted that it is important to note that the association between depression and vitamin D in men was observed at a relatively low level of serum 25(OH)D (<30 nmol/l). In northern latitudes, maintaining vitamin D levels above 30 nmol/l may protect older adults against adverse health conditions which are associated with depression.

Imai CM et al. Depression and serum 25-hydroxyvitamin D in older adults living at northern latitudes – AGES-Reykjavik Study. J Nutr Sci. 2015; 4: e37.

Healthy and Unhealthy Dietary Patterns Are Related to Depression: A Case-Control Study

Major depressive disorder is the leading cause of disability around the world. Depression, based on WHO report, is the fourth most common global burden of all diseases, which might turn into the second most common global burden by the year 2020.

Major depression contains five of the following symptoms, for at least 2 weeks:

  • sad or blue, feeling depressed
  • increased or decreased sleeping
  • absence of interest or enjoyment
  • increased or decreased appetite together with weight change
  • feeling of worthlessness or guilt
  • feeling agitated, feeling unsettled or slowness
  • low energy
  • difficulty in concentration
  • feeling that life is worthless.


The main focus of this study is to investigate the relationship between depression and dietary patterns, rather than one or more specific nutrients.

The authors detected two dietary patterns including “Healthy” and “Unhealthy”. They studied the association between depression and dietary patterns. The study found that the odds ratio of depression was decreased by adhering to healthy dietary patterns, and conversely increased by the consumption of unhealthy dietary patterns.

According to previous studies, a number of nutrients such as omega 3 fatty acids, vitamins D, E, B6, B12, folate, magnesium, zinc, iron, copper, calcium, and tryptophan are important in the prevention and treatment of depression. It is noted that all of food groups in healthy dietary pattern including vegetables, fruits, dairy products, nuts, olive oil and green olive, fish, legumes and whole grains are rich in these nutrients.

This study indicates that healthy and unhealthy dietary patterns may be associated with the risk of depression. The results can be used for developing interventions that aim to promote healthy eating for the prevention of depression.

Khosravi M et al. Healthy and Unhealthy Dietary Patterns Are Related to Depression: A Case-Control Study. Psychiatry Investig. 2015 Oct; 12(4): 434–442.

Adiposity-Based Chronic Disease (ABCD) is a new diagnostic term for obesity

Adiposity-Based Chronic Disease (ABCD) is a new diagnostic term for obesity that explicitly identifies a chronic disease, alludes to a precise pathophysiological basis, and avoids the stigmata and confusion related to the differential use and multiple meanings of the term “obesity”.

Key elements to further the care of patients using this new ABCD term are:

  1. positioning lifestyle medicine in the promotion of overall health, not only as the first algorithmic step, but as the central, pervasive action
  2. standardising protocols that comprehensively and durably address weight loss and management of adiposity-based complications
  3. approaching patient care through contextualisation (e.g., primordial prevention to decrease obesogenic environmental risk factors and transculturalisation to adapt evidence-based recommendations for different ethnicities, cultures, and socio-economics),
  4. developing evidence-based strategies for successful implementation, monitoring, and optimization of patient care over time.

 Component and Description

  • Healthy eating patterns: Aggregation of foods consumed over a specified time and associated with clinical benefit; addresses disordered eating with counselling, group therapy, cognitive behavioural therapy (CBT), and stimulus management
  • Physical activity: Body movements (e.g., aerobic, strength training, sports, exercise, walking); can be employment-related and associated with reduced sedentary activity
  • Body composition: Target %fat mass and fat distribution; implicates muscle mass and intracellular lipid storage
  • Sleep hygiene: Amount and quality of sleep
  • Stress reduction: Relaxation, yoga, meditation, counselling, and CBT
  • Tobacco cessation: Counselling and CBT
  • Alcohol moderation: Spectrum of alcohol use disorder; counselling, and CBT
  • Substance abuse: Counselling and CBT
  • Mood: Counselling, psychotherapy, medical therapy, and physical activity
  • Behaviour: Focus on healthy/unhealthy behaviours; CBT
  • Community engagement: Provide local resources (e.g., houses of worship, schools, neighbourhood centres)
  • Transculturalisation: Adapt recommendations for different ethnicities/cultures

More information: 


Hola from Barcelona

Hola from Barcelona. I’m very excited as I presented a plenary session on nutritional medicine and cardiovascular disease at an international congress to people from over 50 countries. A truly international conference. One of the peaks of my career. I would like to thank my family and friends for all your love and support. Thank you so much. There are a number of you that have a very special place in my heart. You mean so much to me. I’ll never forget what you have done for me. Without you I would not have been able to achieve half of the things I have done. I wish you all the best with lots of love, joy, health, and happiness. Thank you

Apple intake is inversely associated with all-cause and disease-specific mortality in elderly women

Higher fruit intake is associated with lower risk of all-cause and disease-specific mortality. However, data on individual fruits are limited, and the generalisability of these findings to the elderly remains uncertain.

The objective of this study was to examine the association of apple intake with all-cause and disease-specific mortality over 15 years in a cohort of women aged over 70 years. Secondary analyses explored relationships of other fruits with mortality outcomes. Usual fruit intake was assessed in 1456 women using a FFQ. Incidence of all-cause and disease-specific mortality over 15 years was determined through the Western Australian Hospital Morbidity Data system. Cox regression was used to determine the hazard ratios (HR) for mortality. During 15 years of follow-up, 607 (41·7 %) women died from any cause. In the multivariable-adjusted analysis, the HR for all-cause mortality was 0·89 (95 % CI 0·81, 0·97) per sd (53 g/d) increase in apple intake, HR 0·80 (95 % CI 0·65, 0·98) for consumption of 5–100 g/d and HR 0·65 (95 % CI 0·48, 0·89) for consumption of >100 g/d (an apple a day), compared with apple intake of Pfor trend=0·03).

The analysis also found that higher apple intake was associated with lower risk for cancer mortality, and that higher total fruit and banana intakes were associated lower risk of CVD mortality (P<0·05).

The results support the view that regular apple consumption may contribute to lower risk of mortality.

Hodgson JM et al. Br J Nutr. 2016 Jan 20:1-8.

World Thrombosis Day

Recognised on 13 October, World Thrombosis Day (WTD) ( focuses attention on the often overlooked and misunderstood disease of thrombosis. With hundreds of educational events in countries around the world, World Thrombosis Day and its partners place a global spotlight on thrombosis as an urgent and growing health problem.

World Thrombosis Day takes place every year on 13 October, the birthday of Rudolf Virchow who was a pioneer in the pathophysiology of thrombosis. A German physician and pathologist, Virchow developed the concept of “thrombosis” and advanced our understanding of this condition.

World Thrombosis Day seeks to increase global awareness of thrombosis, including its causes, risk factors, signs/symptoms and evidence-based prevention and treatment. Ultimately, we strive to reduce death and disability caused by the disease.

The mission supports the World Health Assembly’s global target of reducing premature deaths by non-communicable disease by 25 percent by 2025, as well as the World Health Organization’s global action plan for the prevention and control of non-communicable diseases between 2013 and 2020.

Worldwide, one in four people die from causes related to thrombosis. Without addressing this disease head on, we cannot meet the World Health Assembly’s global target to reduce premature non-communicable mortality by 25 percent by 2025.

Thrombosis refers to abnormal, life-threatening blood clots that form in the artery or vein. A clot in the vein (usually in the leg or pelvis) is known as a deep vein thrombosis (DVT) and a clot that breaks off and travels to the lungs is known as a pulmonary embolism (PE). Together, DVT and PE make up venous thromboembolism (VTE).

National Nutrition Week 2015 – Pick Right. Feel Bright!

National Nutrition Week 2015 (11-17 October 2015) is all about getting all Australians to enjoy more fruit and vegetables every day with Pick Right. Feel Bright!

Whether they’re fresh, frozen or canned, eating more fruit and vegetables is one of the easiest things we can all do for better health and wellbeing.

Fruits and vegetables burst with flavour and they’re packed full of important vitamins and minerals, disease-fighting antioxidants and gut-healthy fibre.

And they’re so versatile. They can be eaten raw, cooked, poached, baked, mashed, grated, chopped, diced, sliced – you name it!

Visit for a bunch of recipes and fresh ideas to help you buy, grow, cook and enjoy fruit and vegetables.

Take the Try for 5 challenge
Do you think you can eat five serves of vegetables every day during National Nutrition Week?

The FDA takes step to remove artificial trans fats in processed foods

The FDA takes step to remove artificial trans fats in processed foods

Action expected to reduce coronary heart disease and prevent thousands of fatal heart attacks every year  

Based on a thorough review of the scientific evidence, the U.S. Food and Drug Administration today finalised its determination that partially hydrogenated oils, the primary dietary source of artificial trans fat in processed foods, are not “generally recognized as safe” for use in human food. Food manufacturers will have three years to remove partially hydrogenated oils from products.

“The FDA’s action on this major source of artificial trans fat demonstrates the agency’s commitment to the heart health of all Americans,” said FDA’s Acting Commissioner Stephen Ostroff, M.D. “This action is expected to reduce coronary heart disease and prevent thousands of fatal heart attacks every year.”

The effect of omega-3 polyunsaturated fatty acids on fibrin and thrombin generation in healthy subjects and subjects with cardiovascular disease.

Hypercoagulability plays a key role in the progression of cardiovascular disease (CVD). Although omega-3 polyunsaturated fatty acid (PUFA) intake has been inversely related to the risk of cardiovascular events, the mechanisms are not fully understood.

The aim of this study was to investigate the effects of omega-3 on novel markers of global coagulation. The generation of fibrin and thrombin, measured via overall hemostasis potential (OHP) assay and calibrated automated thrombography, respectively, was determined in 40 healthy subjects and 16 patients with CVD at baseline and after 4 weeks of 640 mg/day omega-3 PUFA.

In healthy subjects, fibrin generation was significantly reduced, as measured by overall coagulation potential (p = 0.013), OHP (p < 0.001), velocity of fibrin polymerization (p = 0.002), and significant increase in delay to fibrin generation (p = 0.002). The peak of generated thrombin was significantly reduced (p = 0.043). In subjects with CVD, omega-3 PUFA significantly reduced OHP and significantly increased the lag time to thrombin generation (both p < 0.001). Treatment with omega-3 PUFA had no effect on other fibrin and thrombin generation parameters in CVD patients.

Four-week omega-3 PUFA supplementation reduced thrombotic potential in healthy subjects, as shown by reduced fibrin generation and peak thrombin. There was a greater effect on fibrin generation in healthy subjects compared with those with CVD.

McEwen BJ et al. The effect of omega-3 polyunsaturated fatty acids on fibrin and thrombin generation in healthy subjects and subjects with cardiovascular disease. Semin Thromb Hemost. 2015 Apr;41(3):315-22. (