New research shows “profound” link between dietary choices and brain health

New research has highlighted the profound link between dietary choices and brain health.

Published in Nature, the research showed that a healthy, balanced diet was linked to superior brain health, cognitive function and mental wellbeing. The study, involving researchers at the University of Warwick, sheds light on how our food preferences not only influence physical health but also significantly impact brain health.

The dietary choices of a large sample of 181,990 participants from the UK Biobank were analysed against and a range of physical evaluations, including cognitive function, blood metabolic biomarkers, brain imaging, and genetics – unveiling new insights into the relationship between nutrition and overall wellbeing.

The food preferences of each participant were collected via an online questionnaire, which the team catagorised into 10 groups (such as alcohol, fruits and meats). A type of AI called machine learning helped the researchers analyse the large dataset.

A balanced diet was associated with better mental health, superior cognitive functions and even higher amounts of grey matter in the brain – linked to intelligence – compared with those with a less varied diet.

The study also highlighted the need for gradual dietary modifications, particularly for individuals accustomed to highly palatable but nutritionally deficient foods. By slowly reducing sugar and fat intake over time, individuals may find themselves naturally gravitating towards healthier food choices.

Genetic factors may also contribute to the association between diet and brain health, the scientists believe, showing how a combination of genetic predispositions and lifestyle choices shape wellbeing.

Lead Author Professor Jianfeng Feng, University of Warwick, emphasised the importance of establishing healthy food preferences early in life. He said: "Developing a healthy balanced diet from an early age is crucial for healthy growth. To foster the development of a healthy balanced diet, both families and schools should offer a diverse range of nutritious meals and cultivate an environment that supports their physical and mental health."

Addressing the broader implications of the research, Prof Feng emphasized the role of public policy in promoting accessible and affordable healthy eating options. "Since dietary choices can be influenced by socioeconomic status, it's crucial to ensure that this does not hinder individuals from adopting a healthy balanced dietary profile," he stated. "Implementing affordable nutritious food policies is essential for governments to empower the general public to make informed and healthier dietary choices, thereby promoting overall public health."

Co-Auhtor Wei Cheng, Fudan University, added: “Our findings underscore the associations between dietary patterns and brain health, urging for concerted efforts in promoting nutritional awareness and fostering healthier eating habits across diverse populations.”

Dr Richard Pemberton, Certified Lifestyle Physician and GP, Hexagon Health, who was not involved in the stud, commented: “This exciting research further demonstrates that a poor diet detrimentally impacts not only our physical health but also our mental and brain health. This study supports the need for urgent government action to optimise health in our children, protecting future generations. We also hope this provides further evidence to motivate us all to make better lifestyle choices, to improve our health and reduce the risk of developing chronic disease.”

Read the paper here: https://www.nature.com/articles/s44220-024-00226-0

Strong association between physical activity and better mental health

New research has found a significant association between participating in low to moderate intensity exercise and reduced rates of depression.

 

Researchers from Anglia Ruskin University (ARU) carried out an umbrella review of studies carried out across the world to examine the potential of physical activity as a mental health intervention.

 

The analysis, published in the journal Neuroscience and Biobehavioural Reviews, found that physical activity reduced the risk of depression by 23% and anxiety by 26%. A particularly strong association was found between low and moderate physical activity, which included activities such as gardening, golf and walking, and reduced risk of depression. However, this was not strongly observed for high intensity exercise.

 

Physical activity was also significantly associated with reduced risk of severe mental health conditions, including a reduction in psychosis/schizophrenia by 27%.

 

The results were consistent in both men and women, and across different age groups and across the world.

 

Lead author Lee Smith, Professor of Public Health at Anglia Ruskin University (ARU), said: “Preventing mental health complications effectively has emerged as a major challenge, and an area of paramount importance in the realm of public health. These conditions can be complex and necessitate a multi-pronged approach to treatment, which may encompass pharmacological interventions, psychotherapy, and lifestyle changes.

 

“These effects of physical activity intensity on depression highlight the need for precise exercise guidelines. Moderate exercise can improve mental health through biochemical reactions, whereas high-intensity exercise may worsen stress-related responses in some individuals.

 

“Acknowledging differences in people’s response to exercise is vital for effective mental health strategies, suggesting any activity recommendations should be tailored for the individual.

 

“The fact that even low to moderate levels of physical activity can be beneficial for mental health is particularly important, given that these levels of activity may be more achievable for people who can make smaller lifestyle changes without feeling they need to commit to a high-intensity exercise programme.”

Artificial sweetener neotame can cause healthy gut bacteria to become diseased

 New research has discovered that neotame, one of the new generation of artificial sweeteners, is capable of damaging the human intestine and causing illness.

The study is the first to show that neotame can cause previously healthy gut bacteria to become diseased and invade the gut wall – potentially leading to health issues including irritable bowel syndrome and sepsis – and also cause a breakdown of the epithelial barrier, which forms part of the gut wall.

The research, which is published in the journal Frontiers in Nutrition and was carried out at Anglia Ruskin University (ARU), demonstrates that neotame can damage the intestinal epithelium directly, by causing the death of epithelial cells, and indirectly, by damaging bacteria commonly found in the gut.

The in vitro study identified a range of pathogenic responses following exposure of E. coli (Escherichia coli) and E. faecalis (Enterococcus faecalis) to neotame, which is found in drinks, foods and chewing gums, including biofilm formation and increased adhesion to and invasion of cells by diseased bacteria.

Some of the newest artificial sweeteners have a 1,000-fold sweeter taste compared to sugar, reducing the amount needed to be added to food and drink. Despite the smaller quantities used, the impact of neotame on the epithelium-microbiota relationship has the potential to cause poor gut health, which in turn could lead to metabolic and inflammatory diseases such as irritable bowel disease or insulin resistance.

This new research into neotame builds on previous work by Dr Havovi Chichger of Anglia Ruskin University (ARU), which discovered that saccharin, sucralose, and aspartame, some of the most widely used artificial sweeteners, could cause similar damage in the gut.

Artificial sweeteners can play a role in helping with weight loss and aiding individuals with glucose intolerance and type 2 diabetes. However, this new study, led by Dr Aparna Shil, of Jahangirnagar University in Bangladesh, and Dr Chichger highlights the need for further research into the toxic effects of some of the artificial sweeteners that have been developed more recently.

Dr Chichger, Associate Professor in Biomedical Science at Anglia Ruskin University (ARU) and senior author of the study, said: “There is now growing awareness of the health impacts of sweeteners such as saccharin, sucralose and aspartame, with our own previous work demonstrating the problems they can cause to the wall of the intestine and the damage to the ‘good bacteria’ which form in our gut.

“This can lead to a range of potential health issues including diarrhoea, intestinal inflammation, and even infections such as septicaemia if the bacteria were to enter the blood stream. Therefore, it is important to also study sweeteners that have been introduced more recently and our new research demonstrates that neotame causes similar problems, including gut bacteria becoming diseased.

“Understanding the impact of these pathogenic changes occurring in the gut microbiota is vital. Our findings also demonstrate the need to better understand common food additives more widely and the molecular mechanisms underlying potential negative health impacts.”

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Use of acid reflux drugs linked to higher risk of migraine

 

 People who take acid-reducing drugs may have a higher risk of migraine and other severe headache than people who do not take these medications, according to a study published in the April 24, 2024, online issue of Neurology® Clinical Practice, an official journal of the American Academy of Neurology. The acid-reducing drugs include proton pump inhibitors such as omeprazole and esomeprazole, histamine H2-receptor antagonists, or H2 blockers, such as cimetidine and famotidine, and antacid supplements.

The study does not prove that acid-reducing drugs cause migraine; it only shows an association.

Acid reflux is when stomach acid flows into the esophagus, usually after a meal or when lying down. People with acid reflux may experience heartburn and ulcers. People with frequent acid reflux may develop gastroesophageal reflux disease, or GERD, which can lead to cancer of the esophagus.

“Given the wide usage of acid-reducing drugs and these potential implications with migraine, these results warrant further investigation,” said study author Margaret Slavin, PhD, RDN, of the University of Maryland in College Park. “These drugs are often considered to be overprescribed, and new research has shown other risks tied to long-term use of proton pump inhibitors, such as an increased risk of dementia.”

For the study, researchers looked at data on 11,818 people who provided information on use of acid-reducing drugs and whether they had migraine or severe headache in the past three months.

A total of 25% of participants taking proton pump inhibitors had migraine or severe headache, compared to 19% of those who were not taking the drugs. A total of 25% of those taking H2 blockers had severe headache, compared to 20% of those who were not taking those drugs. And 22% of those taking antacid supplements had severe headache, compared to 20% of those not taking antacids.

When researchers adjusted for other factors that could affect the risk of migraine, such as age, sex and use of caffeine and alcohol, they found that people taking proton pump inhibitors were 70% more likely to have migraine than people not taking proton pump inhibitors. Those taking H2 blockers were 40% more likely and those taking antacid supplements were 30% more likely.

“It’s important to note that many people do need acid-reducing medications to manage acid reflux or other conditions, and people with migraine or severe headache who are taking these drugs or supplements should talk with their doctors about whether they should continue,” Slavin said.

Slavin noted that the study looked only at prescription drugs. Some of the drugs became available for over-the-counter use at non-prescription strength during the study period, but use of these over-the-counter drugs was not included in this study.  

Other studies have shown that people with gastrointestinal conditions may be more likely to have migraine, but Slavin said that relationship is not likely to fully explain the tie between acid-reducing drugs and migraine found in the study.

A limitation of the study is that a small number of people were taking the drugs, especially the H2 blockers.

The consumption of certain food additive emulsifiers could be associated with the risk of developing type 2 diabetes

Peer-Reviewed Publication

In Europe and North America, 30 to 60% of dietary energy intake in adults comes from ultra-processed foods. An increasing number of epidemiological studies suggest a link between higher consumption levels of ultra-processed foods with higher risks of diabetes and other metabolic disorders.

Emulsifiers are among the most commonly used additives. They are often added to processed and packaged foods such as certain industrial cakes, biscuits and desserts, as well as yoghurts, ice creams, chocolate bars, industrial breads, margarines and ready-to-eat or ready-to-heat meals, in order to improve their appearance, taste and texture and lengthen shelf life. These emulsifiers include for instance mono- and diglycerides of fatty acids, carrageenans, modified starches, lecithins, phosphates, celluloses, gums and pectins.

As with all food additives, the safety of emulsifiers had been previously evaluated by food safety and health agencies based on the scientific evidence that was available at the time of their evaluation. However, some recent studies suggest that emulsifiers may disrupt the gut microbiota and increase the risk of inflammation and metabolic disruption, potentially leading to insulin resistance and the development of diabetes.

For more information: read Inserm's report on type 2 diabetes

For the first time worldwide, a team of researchers in France has studied the relationships between the dietary intakes of emulsifiers, assessed over a follow-up period of maximum 14 years, and the risk of developing type 2 diabetes in a large study in the general population.

The results are based on the analysis of data from 104 139 adults in France (average age 43 years; 79% women) who participated in the NutriNet-Santé web-cohort study (see box below) between 2009 and 2023.

The participants completed at least two days of dietary records, collecting detailed information on all foods and drinks consumed and their commercial brands (in the case of industrial products). These dietary records were repeated every six months for 14 years, and were matched against databases in order to identify the presence and amount of food additives (including emulsifiers) in the products consumed. Laboratory assays were also performed in order to provide quantitative data. This allowed a measurement of chronic exposure to these emulsifiers over time.

During follow-up, participants reported the development of diabetes (1056 cases diagnosed), and reports were validated using a multi-source strategy (including data on diabetes medication use). Several well-known risk factors for diabetes, including age, sex, weight (BMI), educational level, family history, smoking, alcohol and levels of physical activity, as well as the overall nutritional quality of the diet (including sugar intake) were taken into account in the analysis.

After an average follow-up of seven years, the researchers observed that chronic exposure – evaluated by repeated data – to the following emulsifiers was associated with an increased risk of type 2 diabetes:

• carrageenans (total carrageenans and E407; 3% increased risk per increment of 100 mg per day)

• tripotassium phosphate (E340; 15% increased risk per increment of 500 mg per day)

• mono- and diacetyltartaric acid esters of mono- and diglycerides of fatty acids (E472e; 4% increased risk per increment of 100 mg per day)

• sodium citrate (E331; 4% increased risk per increment of 500 mg per day)

• guar gum (E412; 11% increased risk per increment of 500 mg per day)

• gum arabic (E414; 3% increased risk per increment of 1000 mg per day)

• xanthan gum (E415; 8% increased risk per increment of 500 mg per day)

This study constitutes an initial exploration of these relationships, and further investigations are now needed to establish causal links. The researchers mentioned several limitations of their study, such as the predominance of women in the sample, a higher level of education than the general population, and generally more health-promoting behaviours among the NutriNet-Santé study participants. Therefore caution is needed when extrapolating the conclusions to the entire French population.

The study is nevertheless based on a large sample size, and the researchers have accounted for a large number of factors that could have led to confounding bias. They also used unique, detailed data on exposure to food additives, down to the commercial brand name of the industrial products consumed. In addition, the results remain consistent through various sensitivity analyses[1], which reinforces their reliability.

'These findings are issued from a single observational study for the moment, and cannot be used on their own to establish a causal relationship. They need to be replicated in other epidemiological studies worldwide, and supplemented with toxicological and interventional experimental studies, to further inform the mechanisms linking these food additive emulsifiers and the onset of type 2 diabetes. However, our results represent key elements to enrich the debate on re-evaluating the regulations around the use of additives in the food industry, in order to better protect consumers,' explain Mathilde Touvier, Research Director at Inserm, and Bernard Srour, Junior Professor at INRAE, lead authors of the study.

Among the next steps, the research team will be looking at variations in certain blood markers and the gut microbiota linked to the consumption of these additives, to better understand the underlying mechanisms. The researchers will also look at the health impact of additive mixtures and their potential 'cocktail effects.' They will also work in collaboration with toxicologists to test the impact of these exposures in in vitro and in vivo experiments, to gather more arguments in favour of a causal link.

PFAS exposure from high seafood diets may be underestimated

 

A Dartmouth-led study suggests that people who frequently consume seafood may face an increased risk of exposure to PFAS, the family of ubiquitous and resilient human-made toxins known as "forever chemicals."

The findings stress the need for more stringent public health guidelines that establish the amount of seafood people can safely consume to limit their exposure to perfluoroalkyl and polyfluoroalkyl substances, the researchers report in the journal Exposure and Health. This need is especially urgent for coastal regions such as New England where a legacy of industry and PFAS pollution bumps up against a cultural predilection for fish, the authors write.

"Our recommendation isn't to not eat seafood—seafood is a great source of lean protein and omega fatty acids. But it also is a potentially underestimated source of PFAS exposure in humans," said Megan Romano, the study's corresponding author and an associate professor of epidemiology at Dartmouth's Geisel School of Medicine.

"Understanding this risk-benefit trade-off for seafood consumption is important for people making decisions about diet, especially for vulnerable populations such as pregnant people and children," Romano said.

The study paired an analysis of PFAS concentrations in fresh seafood with a statewide survey of eating habits in New Hampshire. National data indicate that New Hampshire—along with all of New England— is among the country's top consumers of seafood, which made the state ideal for understanding the extent of people's exposure to PFAS through fish and shellfish.

"Most existing research focuses on PFAS levels in freshwater species, which are not what people primarily eat," said Romano, who studies the effects of PFAS and other endocrine-disrupting chemicals in drinking water on New England communities. "We saw that as a knowledge gap in the literature, especially for a New England state where we know people love their seafood."

The study also drew on New Hampshire's extensive data on the sources and effects of PFAS, which are a staple of consumer products such as plastics and nonstick coatings. The molecular stability that makes PFAS versatile also makes them nearly indestructible, leading them to be called forever chemicals.

In humans, PFAS are associated with cancer, fetal abnormalities, high cholesterol, and thyroid, liver, and reproductive disorders. The chemicals have accumulated in soil, water, and wildlife, and studies have shown that nearly all Americans have measurable amounts in their blood.

"PFAS are not limited to manufacturing, fire-fighting foams, or municipal waste streams—they are a decades-long global challenge," said study co-author Jonathan Petali, a toxicologist with the New Hampshire Department of Environmental Services. "New Hampshire was among the first states to identify PFAS in drinking water. We're a data-rich state due to years spent investigating the impacts of PFAS and trying to mitigate exposure."

The researchers measured the levels of 26 varieties of PFAS in samples of the most consumed marine species: cod, haddock, lobster, salmon, scallop, shrimp, and tuna. The seafood studied was purchased fresh from a market in coastal New Hampshire and originated from various regions.

Shrimp and lobster clocked the highest concentrations with averages ranging as high as 1.74 and 3.30 nanograms per gram of flesh, respectively, for certain PFAS compounds, the researchers report. Concentrations of individual PFAS in other fish and seafood measured generally less than one nanogram per gram.

The prevalence of PFAS in the environment makes it difficult to know exactly where and how the chemicals enter the marine food chain, the researchers report. Some shellfish may be especially vulnerable to the buildup of PFAS in their flesh due to feeding and living on the seafloor, as well as their proximity to sources of PFAS that are near the coast. Larger marine species may ingest PFAS by eating smaller species that, like shellfish, are prone to having the compounds accumulate in their systems. 

Buttressing the study is a survey of 1,829 New Hampshire residents the researchers conducted to gauge how much seafood Granite Staters eat—and it's a lot.

The survey found that men in New Hampshire eat just over one ounce of seafood per day and women eat just under one ounce. Both are higher than what the National Health and Nutrition Examination Survey found for men and women in the Northeast, and more than 1.5 times the national average for both. Daily intake for New Hampshire children aged 2 to 11 years old was about 0.2 ounces, the highest end of the range for children nationwide.

About 95% of adults the researchers surveyed reported they ate seafood within the past year, and 94% of that group consumed fish or shellfish within the previous month. More than two-thirds of those respondents ate seafood within the past week.

But people in New Hampshire do not eat seafood uniformly. More than half of the people who ate seafood in the week before the survey lived on the state's coast or near the border with Massachusetts. More than 60% of people with a household income below $45,000 per year reported consuming seafood at least once per week, whereas people with higher household incomes reported eating seafood less often.  

Of the species the researchers tested for PFAS, shrimp, haddock, and salmon were consumed by more than 70% of the adults who ate seafood once a month or more. Lobster was eaten by just over 54% of these adults. Salmon, canned tuna, shrimp, and haddock were the most commonly consumed species among children.

Federal guidelines for safe seafood consumption exist for mercury and other contaminants, but there are none for PFAS, said Celia Chen, a co-author of the study and a research professor in the Department of Biological Sciences at Dartmouth.

"Top predator species such as tuna and sharks are known to contain high concentrations of mercury, so we can use that knowledge to limit exposure. But it's less clear for PFAS, especially if you start looking at how the different compounds behave in the environment," said Chen, who leads several federally funded projects examining how and where PFAS accumulate in aquatic food webs in New Hampshire and Vermont.

The establishment of safety guidelines would help protect people who are especially susceptible to pollutants, said Kathryn Crawford, the study's first author and an assistant professor of environmental studies at Middlebury College.

"Seafood consumption advisories often provide advice for those individuals that is more conservative than for the rest of the population," said Crawford, who began the project as a postdoctoral researcher in the Romano Lab at Dartmouth. "People who eat a balanced diet with more typical, moderate amounts of seafood should be able to enjoy the health benefits of seafood without excessive risk of PFAS exposure."

Natural supplement to prevent postpartum blues

 

Product now available in the U.S. with global distribution plannedA new study published in the Lancet discovery science  journal eClinicalMedicine has confirmed that a novel natural supplement—invented, researched, developed and commercialized at the Centre for Addiction and Mental Health (CAMH)—prevents postpartum blues, and reduces symptoms of postpartum depression over the following six months after giving birth.

Up to 8 out of ten new mothers experience postpartum, or ‘baby,’ blues, characterized by mood swings, crying spells, anxiety and difficulty sleeping. The condition usually begins within the first few days after delivery and may last for up to two weeks. Postpartum blues strongly raises the risk of postpartum depression, a serious mental illness affecting 13 per cent of mothers. Postpartum depression has important health care consequences: impairing quality of life, increasing risk for future depressive episodes and suicide, and is associated with cognitive and emotional effects in children. Until now, options for widespread prevention have been lacking for either condition.

The study, entitled Dietary Supplement for Mood Symptoms in Early Postpartum: A Double-Blind Randomized Placebo Controlled Trial, involved more than 100 postpartum participants between January 2019 and December 2022 who either took four doses of the natural supplement several days after giving birth, or a matching placebo. Within the supplement group, two-thirds (66 per cent) experienced either no symptoms or only negligible symptoms of postpartum blues. Furthermore, in the following six months, participants who received the supplement experienced less symptoms of depression with none reaching the clinical threshold of postpartum depression six months after giving birth.

“Globally 140 million births take place every year. Most women then experience postpartum blues, which, when severe, increases the likelihood of getting full-blown postpartum depression at least fourfold. Our study showed that both postpartum blues and later symptoms of depression were lower in women who received the dietary supplement,” said Dr. Jeffrey Meyer, inventor of the nutraceutical and study senior author. “Providing this specialized dietary support in the first few days after giving birth is a crucial window to avoid depressive symptoms which is tremendously important given there is considerable risk that they may recur and have lifelong impact.”

Dr. Meyer has been investigating postpartum blues for more than 15 years. His previous imaging research found that a protein called MAO-A rises dramatically in the brains of postpartum women and this protein removes important brain chemicals—like serotonin and dopamine—that support normal mood. It also acts as an oxidant and is linked to the development and progression of certain mental illnesses. To combat this effect, the nutraceutical is made up of a patented unique combination of natural ingredients, including blueberry extract, which contain antioxidants, and amino acids that replenish essential neurochemicals in the brain to support healthy mood and the ability to concentrate under stress. The supplement was well tolerated and women who took it tended to report less symptoms, in part due to less drowsiness, headache and restlessness. The researchers previously showed that the amino acids in the supplement do not affect their total concentrations in breast milk, which was expected since these amino acids are already found in proteins in breast milk.     

CAMH has partnered with international women’s health supplement and pharmaceutical company Exeltis via a licensing agreement to bring the product to market under the name Blues Away®. Exeltis has maintained the natural health product approach in their preparations and manufacture for widespread distribution of the supplement. It is expected that the product will be available for sale in the U.S. beginning April 11, 2024.  It is also in the process of being brought to other global markets—including Canada—with the pace of approvals being dependent on each country’s regulatory requirements and reviews. 

“We are thrilled to unveil the culmination of years of dedication and collaboration in the form of our groundbreaking nutraceutical for postpartum blues prevention. It is great that we are able to simultaneously share our clinical research around this product while also partnering with a  global women’s health industry leader to make it available to the new mothers who need it,” said Klara Vichnevetski, Director of Industry Partnerships and Technology Transfer. CAMH has nurtured this innovation from its inception, guiding it from bench to bedside where it can make an immediate and profound difference in the lives of millions of women and their families.”

A limitation of the study was that, of th