Medical Bulletin 01/ August/ 2024

According to a study published in journal neuropsychiatric disease and treatment, It is known that elevated serum homocysteine, decreased folate, and low vitamin B12 serum levels are associated with poor cognitive function, cognitive decline, and dementia. Current literature shows that some psychiatric disorders, mainly affective and psychotic ones, can be related to the levels of vitamin B12, folate, and homocysteine. These results can be explained by the importance of vitamin B12, folate, and homocysteine in carbon transfer metabolism (methylation), which is required for the production of serotonin as well as for other monoamine neurotransmitters and catecholamines.

Patients who were diagnosed with OCD according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria were approached and informed about the aims and methods of the study. Among the patients, the ones who did not have mental retardation and/or psychosis, and the ones who provided their informed consent were enrolled in the study. Other exclusion criteria were defined as the history of any endocrinological condition, being pregnant, lactating or having childbearing potential, having clinically relevant abnormal laboratory test results, including megaloblastic anaemia, alcohol abuse and dependence and a positive history of immunologic disease. Twenty-two healthy control subjects who matched with the patients in terms of sex and age were chosen from the hospital staff according to exclusion criteria.

While the mean age of the patient group was 34.0±10.5 years, it was 33.1±8.3 years in the controls. The patient and control groups were mostly female (88.6% and 86.4%, respectively). The groups had no significant differences in terms of their sociodemographic data. The mean age at onset of OCD was 22.1±8.5 years and the mean duration of OCD was 141.8±111.0 months in the patient group.

This study showed that some of the patients with OCD had vitamin B12 deficiency and higher homocysteine levels. However, the sample was too small to conclude that this finding is an important biological indicator for OCD. Although more detailed studies regarding this phenomenon are to be carried out, these findings can provide a starting point for future research.

References: Fafouti M, Paparrigopoulos T, Liappas J, Mantouvalos V, Typaldou R, Christodoulou G. Mood disorder with mixed features due to vitamin B12 and folate deficiency. Gen Hosp Psychiatry. 2002;24(2):106–109.

A study published in a journal cancer screening and prevention, Cancer is a complex, multifactorial disease with a substantial global burden. Recent years have seen a surge in research focusing on preventive measures, particularly through diet and supplements. The role of nutrition in cancer incidence and prevention is widely recognized, though the specifics of these relationships remain under investigation. This review expands on the findings of Anandu Chandra Khanashyam exploring the nuanced links between diet, supplements, and cancer prevention. The significance of diet and supplements in cancer prevention is well-documented, with nutrition being a key factor in cancer incidence.

Shifting from a nutrient-centric approach to examining overall dietary patterns offers a more comprehensive understanding of diet's impact on cancer risk. Healthy dietary patterns, characterised by high intake of fruits, vegetables, and whole grains, are associated with a lower risk of cancers, particularly colon and breast cancer.

While certain micronutrients and antioxidants, such as vitamins B12, D, C, selenium, folic acid, and carotenoids, have shown potential in cancer prevention, their indiscriminate use can be harmful. Well-nourished individuals might not benefit from additional supplements, and excessive intake could increase cancer risk.

Lifestyle and dietary habits significantly influence cancer risk. Adopting a balanced diet rich in fruits, vegetables, whole grains, and legumes can lower cancer risk. Antioxidants in these foods help repair cells and reduce inflammation, counteracting cancer cell mechanisms. While epidemiological and clinical research has advanced our understanding of diet and cancer prevention, further studies are necessary to clarify these relationships.

References: Khanashyam, A. C., et al. (2023). Diet and Supplements in Cancer Prevention. doi.org/10.14218/csp.2023.00001.

In a recent study published in journal nutrients, Type 2 diabetes mellitus (T2DM) is a chronic condition marked by elevated blood glucose levels due to pancreatic beta-cell dysfunction and reduced insulin action. T2DM and depression have a bidirectional relationship, with affected individuals facing challenges such as disability-related job loss, noncompliance with medical treatment, and heightened mortality risks.

In this double-blind, placebo-controlled randomised controlled trial (RCT), researchers assessed the depression-lowering effects of curcumin in 227 obese individuals with type 2 diabetes mellitus (T2DM). The study emphasised the role of curcumin's antioxidant and anti-inflammatory properties in elevating serotonin levels.Participants were individuals aged 35 and above who had received a T2DM diagnosis within the past year.

At one year, curcumin consumers showed significantly lowered depression severity, as indicated by a 20% improvement in PHQ-9 scores with elevated serotonin and lower IL-1β, IL-6, and TNF-α levels compared to placebo recipients. The anti-inflammatory properties of curcumin extracts may elevate serum serotonin levels.

The study found curcumin effective and safe for lowering depression severity in obese individuals with T2DM. Curcumin may help alleviate depression by raising serotonin levels, reducing inflammation, and decreasing oxidative stress.

References: Yaikwawong, M.; Jansarikit, L.; Jirawatnotai, S.; Chuengsamarn, S. (2024) Curcumin Reduces Depression in Obese Patients with Type 2 Diabetes: A Randomized Controlled Trial. Nutrients. doi: https:// doi.org/10.3390/nu16152414. https://www.mdpi.com/2072-6643/16/15/2414

In a recent study published in the journal Nature Communications, researchers investigated the association between alterable lifestyle factors and complications after having coronavirus disease 2019 (COVID-19). Long COVID affects a range of systemic diseases or symptoms across 10 organ systems, including cardiovascular, coagulation, metabolic, gastrointestinal, kidney, mental health, musculoskeletal, neurologic, and respiratory disorders, as well as general symptoms of fatigue and malaise, severely impacting the quality of life and daily life.

Researchers aimed to fill a critical knowledge gap by examining how a combination of healthy lifestyle factors, particularly regular physical activity, a healthy diet, and avoiding smoking, might reduce the risk of developing long COVID symptoms across various organ systems. The study considered factors like infection severity, vaccination status, and different COVID-19 variants.

The study examined 68,896 participants from the UK Biobank project who tested positive for COVID-19 between 2020 and 2022. The participants had an average age of 66.6 years, with 53.4% being male and 82.1% identifying as White.

The study reveals that maintaining a healthy lifestyle prior to contracting COVID-19 significantly reduces the risk of severe outcomes, such as multisystem complications, hospitalisation, and death, during both the acute and post-acute phases of the disease.

References: Modifiable lifestyle factors and the risk of post-COVID-19 multisystem sequelae, hospitalisation, and death. Wang, Y., Su, B., Alcalde-Herraiz, M., Barclay, N. L., Tian, Y., Li, C., Wareham, N. J., Paredes, R., Xie, J., Prieto-Alhambra, D. Nature Communications (2024). DOI: 10.1038/s41467-024-50495-7, https://www.nature.com/articles/s41467-024-50495-7