For women with antenatal depression, micronutrients might help them and their babies – new study
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Julia J Rucklidge, University of Canterbury; Elena Moltchanova, University of Canterbury; Roger Mulder, University of Otago, and Siobhan A Campbell, University of Canterbury
Antenatal depression affects 15% to 21% of pregnant women worldwide. It can influence birth outcomes and children’s development, as well as increase the risk of post-natal depression.
Current treatments like therapy can be inaccessible and antidepressants can carry risks for developing infants.
Over the past two decades, research has highlighted that poor nutrition is a contributing risk factor to mental health challenges. Most pregnant women in New Zealand aren’t adhering to nutritional guidelines, according to a longitudinal study. Only 3% met the recommendations for all food groups.
Another cohort study carried out in Brazil shows that ultra-processed foods (UPF) accounted for at least 30% of daily dietary energy during pregnancy, displacing healthier options.
UPFs are chemically manufactured and contain additives to improve shelf life, as well as added sugar and salt. Importantly, they are low in essential micronutrients (vitamins and minerals).
The consumption of these foods is concerning because a nutrient-poor diet during pregnancy has been linked to poorer mental health outcomes in children. This includes depression, anxiety, hyperactivity, and inattention.
Increasing nutrients in maternal diets and reducing consumption of UPFs could improve the mental health of the mother and the next generation. Good nutrition can have lifelong benefits for the offspring.
However, there are multiple factors that mean diet change alone may not in itself be sufficient to address mental health challenges. Supplementing with additional nutrients may also be important to address nutritional needs during pregnancy.
Micronutrients as treatment for depression
Our earlier research suggests micronutrient supplements for depression have benefits outside pregnancy.
But until now there have been no published randomised controlled trials specifically designed to assess the efficacy and safety of broad-spectrum micronutrients on antenatal depression and overall functioning.
The NUTRIMUM trial, which ran between 2017 and 2022, recruited 88 women in their second trimester of pregnancy who reported moderate depressive symptoms. They were randomly allocated to receive either 12 capsules (four pills, three times a day) of a broad-spectrum micronutrient supplement or an active placebo containing iodine and riboflavin for a 12-week period.
Micronutrient doses were generally between the recommended dietary allowance and the tolerable upper level.
Based on clinician ratings, micronutrients significantly improved overall psychological functioning compared to the placebo. The findings took into account all noted changes based on self-assessment and clinician observations. This includes sleep, mood regulation, coping, anxiety and side effects.
Both groups reported similar reductions in symptoms of depression. More than three quarters of participants were in remission at the end of the trial. But 69% of participants in the micronutrient group rated themselves as “much” or “very much” improved, compared to 39% in the placebo group.
Participants taking the micronutrients also experienced significantly greater improvements in sleep and overall day-to-day functioning, compared to participants taking the placebo. There were no group differences on measures of stress, anxiety and quality of life.
Importantly, there were no group differences in reported side effects, and reports of suicidal thoughts dropped over the course of the study for both groups. Blood tests confirmed increased vitamin levels (vitamin C, D, B12) and fewer deficiencies in the micronutrient group.
Micronutrients were particularly helpful for women with chronic mental health challenges and those who had taken psychiatric medications in the past. Those with milder symptoms improved with or without the micronutrients, suggesting general care and monitoring might suffice for some women.
The benefits of micronutrients were comparable to psychotherapy but with less contact. There are no randomised controlled trials of antidepressant medication to compare these results.
Retention in the study was good (81%) and compliance excellent (90%).
Beyond maternal mental health
We followed the infants of mothers enrolled in the NUTRIMUM trial (who were therefore exposed to micronutrients during pregnancy) for 12 months, alongside infants from the general population of Aotearoa New Zealand.
This second group of infants from the general population contained a smaller sub-group who were exposed to antidepressant medication for the treatment of antenatal depression.
We assessed the neuro-behavioural development of each infant within the first four weeks of life, and temperament up to one year after birth.
These observational follow-ups showed positive effects of micronutrients on the infants’ ability to regulate their behaviour. These results were on par with or better than typical pregnancies, and better than treatments with antidepressants.
Infants exposed to micronutrients during pregnancy were significantly better at attending to external stimuli. They were also better able to block out external stimuli during sleep. They showed fewer signs of stress and had better muscle tone compared to infants not exposed to micronutrients.
They also displayed greater ability to interact with their environment. They were better at regulating their emotional state and had fewer abnormal muscle reflexes than infants exposed to antidepressant medication in pregnancy.
Reassuringly, micronutrients had no negative impact on infant temperament.
These findings highlight the potential of micronutrients as a safe and effective alternative to traditional medication treatments for antenatal depression.
The prenatal environment sets the foundation for a child’s future. Further investigation into the benefits of micronutrient supplementation would gives us more confidence in their use for other perinatal (from the start of pregnancy to a year after birth) mental health issues. This could provide future generations with a better start to life.
We would like to acknowledge the contribution of Dr Hayley Bradley to this research project.
Julia J Rucklidge, Professor of Psychology, University of Canterbury; Elena Moltchanova, Professor of Statistics, University of Canterbury; Roger Mulder, Professor of Psychiatry, University of Otago, and Siobhan A Campbell, Intern Psychologist, Researcher – Te Puna Toiora (Mental Health and Nutrition Research Lab), University of Canterbury
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Simple Six – by Clinton Dobbins
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We at 10almonds don’t believe in keeping things a mystery, so…
“The Simple Six” are:
- the squat
- the goblet squat
- the hinge
- the kettlebell swing
- the push
- the push-up
- the kettle-bell press
- the pull
- the chin-up
- the gait, and
- walking.
Ok, we’re being a little glib here because to be fair, those are chunked into six groups, but the point is: don’t let the title fool you into thinking the book could have been an article; there’s plenty of valuable content here.
That said, it is a short book (64 pages), but with an average of 10 pages per exercise type, it’s a lot more than for example we could ever put into our newsletter.
Bottom line: we know that 10almonds readers like simple, clear, evidence-based, to-the-point health information, and that’s what this book is, so we do recommend it.
Click here to check out The Simple Six, and streamline your workouts!
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Take Care Of Your “Unwanted” Parts Too!
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Meet The Family…
If you’ve heard talk of “healing your inner child” or similar ideas, then today’s featured type of therapy takes that to several extra levels, in a way that helps many people.
It’s called Internal Family Systems therapy, often “IFS” for short.
Here’s a quick overview:
Psychology Today | Internal Family Systems Therapy
Note: if you are delusional, paranoid, schizophrenic, or have some other related disorder*, then IFS would probably be a bad idea for you as it could worsen your symptoms, and/or play into them badly.
*but bipolar disorder, in its various forms, is not usually a problem for IFS. Do check with your own relevant healthcare provider(s), of course, to be sure.
What is IFS?
The main premise of IFS is that your “self” can be modelled as a system, and its constituent parts can be examined, questioned, given what they need, and integrated into a healthy whole.
For example…
- Exile is the name given to parts that could be, for example, the “inner child” referenced in a lot of pop-psychology, but it could also be some other ignored and pushed-down part of oneself, often from some kind of trauma. The defining characteristic of an exile is that it’s a part of ourself that we don’t consciously allow ourselves to see as a current part of ourself.
- Protector is the name given to a part of us that looks to keep us safe, and can do this in an adaptive (healthy) or maladaptive (unhealthy) way, for example:
- Firefighter is the name given to a part of us that will do whatever is necessary in the moment to deal with an exile that is otherwise coming to the surface—sometimes with drastic actions/reactions that may not be great for us.
- Manager is the name given to a part of us that has a more nurturing protective role, keeping us from harm in what’s often a more prophylactic manner.
To give a simple illustration…
A person was criticized a lot as a child, told she was useless, and treated as a disappointment. Consequently, as an adult she now has an exile “the useless child”, something she strives to leave well behind in her past, because it was a painful experience for her. However, sometimes when someone questions and/or advises her, she will get defensive as her firefighter “the hero” will vigorously speak up for her competence, like nobody did when she was a child. This vigor, however, manifests as rude abrasiveness and overcompensation. Finally, she has a manager, “the advocate”, who will do the same job, but in a more quietly confident fashion.
This person’s therapy will look at transferring the protector job from the firefighter to the manager, which will involve examining, questioning, and addressing all three parts.
The above example is fictional and created for simplicity and clarity; here’s a real-world case study if you’d like a more in-depth overview of how it can work:
How it all fits together in practice
IFS looks to make sure all the parts’ needs are met, even the “bad” ones, because they all have their functions.
Good IFS therapy, however, can make sure a part is heard, and then reassure that part in a way that effectively allows that part to “retire”, safe and secure in the knowledge that it has done what it needed to, and/or the job is being done by another part now.
That can involve, for example, thanking the firefighter for looking after our exile for all these years, but that our exile is safe and in good hands now, so it can put that fire-axe away.
See also: On Being Reactive vs Being Responsive
Questions you might ask yourself
While IFS therapy is best given by a skilled practitioner, we can take some of the ideas of it for self-therapy too. For example…
- What is a secret about yourself that you will take to the grave? And now, why did that part of you (now an exile) come to exist?
- What does that exile need, that it didn’t get? What parts of us try to give it that nowadays?
- What could we do, with all that information in mind, to assign the “protection” job to the part of us best-suited to healthy integration?
Want to know more?
We’ve only had the space of a small article to give a brief introduction to Family Systems therapy, so check out the “resources” tab at:
IFS Institute | What Is Internal Family Systems Therapy?
Take care!
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Feta or Parmesan – Which is Healthier?
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Our Verdict
When comparing feta to parmesan, we picked the parmesan.
Why?
It’s close! Looking at the macros, parmesan has more protein and slightly less fat. Of the fat content, parmesan also has slightly less saturated fat, but neither of them are doing great in this category. Still, a relative win for parmesan.
In the category of vitamins, feta is a veritable vitamin-B-fest with more of vitamins B1, B2, B3, B5, B6, and B9. On the other hand, parmesan has more of vitamins A, B12, and choline. By strength of numbers, this is a win for feta.
Minerals tell a different story; parmesan has a lot more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc. Meanwhile, feta is not higher in any minerals. A clear win for parmesan.
Both cheeses offer gut-healthy benefits (if consumed regularly in small portions), while neither are great for the heart.
On balance, we say parmesan wins the day.
Want to learn more?
You might like to read:
Feta Cheese vs Mozzarella – Which is Healthier?
Take care!
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Gut Renovation – by Dr. Roshini Raj, with Sheila Buff
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Unless we actually feel something going on down there, gut health is an oft-neglected part of overall health—which is unfortunate, because invisible as it may often be, it affects so much.
Gastroenterologist Dr. Roshini Raj gives us all the need-to-know information, explanations of why things happen the way they do with regard to the gut, and tips, tricks, and hacks to improve matters.
She also does some mythbusting along the way, and advises about what things don’t make a huge difference, including what medications don’t have a lot of evidence for their usefulness.
The style is easy-reading pop-science, with plenty of high-quality medical content.
Reading between the lines, a lot of the book as it stands was probably written by the co-author, Sheila Buff, who is a professional ghostwriter and specializes in working closely with doctors to produce works that are readable and informative to the layperson while still being full of the doctor’s knowledge and expertise. So a reasonable scenario is that Dr. Raj gave her extensive notes, she took it from there, passed it back to her for medical corrections, and they had a little back and forth until it was done. Whatever their setup, the end result was definitely good!
Bottom line: if you’d like a guide to gut health that’s practical and easy to read, while being quite comprehensive and certainly a lot more than “eat probiotics and fiber”, then this book is a fine choice.
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Lyme Disease At-A-Glance
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Good info as always…was wondering if you have any recommendations for fighting Lyme disease naturally along wDr advice? Dr’s aren’t real keen on alternatives so always interested. Thanks❞
That depends on whether we’re looking at prevention or cure!
Prevention:
- Try not to get bitten by Lyme-disease-carrying ticks. Boots and long socks are your friends. As are long-gauntletted gloves for gardening.
- If you are in a high-risk area and/or engage in high-risk activities, check your body daily.
- This is because it usually takes 36–48 hours of being attached for a tick to cause an infection
- Obviously best if you can get a partner or close friend to help you with this, unless you have mastered some advanced pretzel positions of yoga.
- Contrary to many folk remedies, the safest way to remove a tick is with tweezers (carefully!).
- If you find and remove a tick, or otherwise suspect you have developed symptoms, go to your doctor immediately (not next week; today; time really counts for this).
Cure:
- No. Sorry. Regretfully, antibiotics are the only known effective treatment.
However! As with almost any kind of recovery, getting good rest, including good quality sleep, will hasten things. Also sensible is reducing stress if possible, and anything that could worsen inflammation.
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Reversing Alzheimer’s – by Dr. Heather Sandison
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The title here is bold, isn’t it? But, if the studies so far are anything to go by, she is, indeed, reversing Alzheimer’s. By this we mean: her Alzheimer’s patients have enjoyed a measurable reversal of the symptoms of cognitive decline (this is not something that usually happens).
The science here is actually new, and/but references are given aplenty, including Dr. Sandison’s own research and others—there’s a bibliography of several hundred papers, which we love to see.
Dr. Sandison’s approach is of course multivector, but is far more lifestyle medicine than pills, with diet in particular playing a critical role. Indeed, it’s worth mentioning that she is a naturopathic doctor (not an MD), so that is her focus—though she’s had a lot of MDs looking in on her work too, as you may see in the book. She has found best results in a diet low in carbs, high in healthy fats—and it bears emphasizing, healthy ones. Many other factors are also built in, but this is a book review, not a book summary.
Nor does the book look at diet in isolation; other aspects of lifestyle are also taken into account, as well as various medical pathways, and how to draw up a personalized plan to deal with those.
The book is written with the general assumption that the reader is someone with increased Alzheimer’s risk wishing to reduce that risk, or the relative of someone with Alzheimer’s disease already. However, the information within is beneficial to all.
The style is on the hard end of pop-science; it’s written for the lay reader, but will (appropriately enough) require active engagement to read effectively.
Bottom line: if Alzheimer’s is something that affects or is likely to affect you (directly, or per a loved one), then this is a very good book to have read
Click here top check out Reversing Alzheimer’s, and learn how to do it!
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