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Vitamin D Supplementation Affects the Beck Depression Inventory, Insulin Resistance, and Biomarkers of Oxidative Stress
Research Critique of “Vitamin D Supplementation Affects the Beck Depression Inventory, Insulin Resistance, and Biomarkers of Oxidative Stress in Patients with Major Depressive Disorder: A Randomized, Controlled Clinical Trial”
Alexandra Grossano
September 24, 2018
Vitamin D is produced in the skin by sun exposure and has many important functions in the human body. These functions include: calcium maintenance for bone health, as well as roles in brain development and function CITATION Jor08 l 1033 (1). Vitamin D is said to have a profound impact on neurotransmitters and, it has also shown in research to have antidepressant properties CITATION Par17 l 1033 (2). Studies have suggested that the brain has specialized receptors for vitamin D that contribute to mood and depressive disorders CITATION Par11 l 1033 (3). Low serum levels of 25-hydoxyvitamin D [25(OH)D], the storage form of vitamin D, have been associated with reduced cognitive function as well as anxiety and depression CITATION Jor08 l 1033 (1). Vitamin D deficiency has been associated with an 8-14% increase in the prevalence of depression and a 50% increase in the prevalence of suicide CITATION Sep16 l 1033 (4). There is evidence to support the hypothesis that low vitamin D status is associated with mood disorder, including major depressive disorder and seasonal affective disorder CITATION Cho18 l 1033 (5). Major Depressive Disorder (MDD) is defined as a mental disorder that is characterized by persistent low mood, accompanied by loss of interest or pleasure in normally enjoyable activities CITATION Sep16 l 1033 (4). One study showed that 95 % of patients with MDD had a serum-hydroxyvitamin D concentration below 30 micrograms per liter CITATION Sep16 l 1033 (4). Vitamin D has shown to improve depressive symptoms through its effects on neurotransmitters such as serotonin CITATION Cho18 l 1033 (5), inflammatory markers, calcium homeostasis in the brain and nerve growth factor synthesis CITATION Sep16 l 1033 (4).
A one-month, randomized, double blind, placebo-controlled clinical trial done by Sepehrmanesh, Z., and Kolahdooz, F., et. Al. examined 40 patients between the ages of 18 and 65 who had been diagnosed with MDD based on the disease criteria from the Diagnostic and Statistical Manual of Mental Disorders CITATION Sep16 l 1033 (4). Exclusion criteria included: a history of coronary artery infarction, angina pectoris, stroke, renal stone disease, pregnant or lactating women, smokers and those with liver problems or substance abuse problems, those having non-normal creatinine concentrations or taking dietary supplements during the previous two months CITATION Sep16 l 1033 (4). Participants were randomly assigned to received either a single capsule of Vitamin D, or a placebo every week for eight weeks. Fasting blood samples were taken before and after the study. Both Primary and secondary outcomes were assessed; Primary measures included the Beck Depression Inventory (BDI) which is a self-compiled questionnaire in multiple-choice format that examines depressive symptoms CITATION Sep16 l 1033 (4). Secondary measures included: glucose homeostasis variables, lipid profiles, hs-CRP, and biomarkers of oxidative stress CITATION Sep16 l 1033 (4). Patients were asked to not change their routine physical activity or dietary intake for the duration of the study CITATION Sep16 l 1033 (4). Participants provided three dietary records and three physical activity records both were obtained at two, four, and six weeks of the study CITATION Sep16 l 1033 (4). Physical activity was expressed in metabolic equivalents (hours/day) by multiplying the time reported for physical activity by the relevant metabolic equivalent coefficients found in standard tables CITATION Sep16 l 1033 (4). A trained nutritionist obtained anthropometric measurements both pre and postintervention. In addition to short reminder messages, participants were asked to return empty medication packages to ensure compliance CITATION Sep16 l 1033 (4). Nutritionist IV software, modified for Iranian foods, was used to obtain nutrient intake for the participants CITATION Sep16 l 1033 (4).
After the eight weeks, changes in serum 25-hydroxyvitamin D concentrations were greater in the vitamin D group than in the placebo group CITATION Sep16 l 1033 (4). A trend in a greater decrease of BDI score was observed in those who took the vitamin D supplements compared to those in the placebo group CITATION Sep16 l 1033 (4). There were no significant differences in height, weight, physical activity, or baseline BMI between the vitamin D group and the placebo CITATION Sep16 l 1033 (4). There were no statistically significant differences seen between groups in terms of dietary intake of energy, carbohydrates, proteins, fats, cholesterol, dietary fiber, vitamin D, calcium, etc. CITATION Sep16 l 1033 (4). Patients who took the vitamin D supplement had significant decreases in the serum insulin concentrations, HOMA-IR, and HOMA-B compared to the placebo group CITATION Sep16 l 1033 (4). MDD is linked to complications such as morbidity, mortality, increased risk of cardiovascular disease, dyslipidemia, and impaired insulin function CITATION Sep16 l 1033 (4).
Low serum 25-hyrdroxyvitamin D levels have been seen in overweight and obese subjects, individuals with depression as well as those with seasonal affective disorder (SAD) CITATION Jor08 l 1033 (1). There is an apparent relationship between 25-hydroxyvitamin D levels and symptoms of depression CITATION Jor08 l 1033 (1). Many studies on the relation between blood 25-hydroxyvitamin D levels and incidence of depression have been limited by physical activity, body mass index, length of study as well as other factors that may be associated with depression CITATION Ber12 l 1033 (6). There is room for further research on the effects of supplementation of vitamin D and depression symptoms in otherwise healthy adults for longer periods of time CITATION Cho18 l 1033 (5). Other exploration into the effects of vitamin D supplementation on patients without a deficiency may help to distinguish how supplementation impacts those with and without deficiency CITATION Sep16 l 1033 (4). One study focused on vitamin D levels and their relationship to depression disorders in a population with musculoskeletal pain (MSP), this study found that supplementation with vitamin D improved MSP and other associated disorders CITATION Abd18 l 1033 (7).
Vitamin D is essential for calcium homeostasis as well as neurodevelopment and function CITATION Anj18 l 1033 (8). Low vitamin D status is linked to a range of different mood disorders such as major depressive disorder (MDD) and other problems such as dementia, depression, diabetes mellitus, autism and schizophrenia CITATION Cho18 l 1033 (5). MDD is characterized by persistent low mood with a loss of interest or pleasure in normally enjoyable activities CITATION Sep16 l 1033 (4). Supplementation with vitamin D in patients with MDD has a beneficial impact on BDI scores, markers of glucose metabolism an oxidative stress CITATION Sep16 l 1033 (4). Vitamin D supplementation with high doses alleviates symptoms of depression indicating a casual relationship between vitamin D levels and depression CITATION Jor08 l 1033 (1).
Bibliography
BIBLIOGRAPHY 1. Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomized double blind trial. Jorde, R., Sneve, M., Figenschau, Y., Et. al. 6, 2008, Journal of Internal Medicine, Vol. 264.
2. Vitamin D and Depression. Parker, G.B., Brotchie, H., Graham, R. K. 15, 2017, Journal of Affective Disorders, Vol. 208, pp. 56-61.
3. ‘D’ for depression: any role for vitamin D? Parker, G., Brotchie, H. 4, 2011, Acta Psychiatrica Scandinavica, Vol. 124, pp. 243-249.
4. Vitamin D Supplementaion Affects Becks Depression Inventory, Insulin Resistance, and Biomarkers of Oxidative Stess in Patients with Major Depressive Disorder: A Randomized, Controlled Clinical Trial. Sepehrmanesh, Z., Kolahdooz, F., Abedi, F., et al. 2, 2016, The Journal of Nutrition, Vol. 146, pp. 243-248.
5. Effect of Vitamin D Supplementation on depressive symptoms and psychological wellbeing in healthy adult women : a double-blind radomised conrtolled clinical trial. Choukri, M.A., Conner, T.S., Haszard, J.J., et al. s.l. : Journal of Nutritional Science, 2018, Vol. 7.
6. Vitamin D Supplementation and Depression in the Womens Health Initiative Calcium and Vitmain D Trial. Bertone-Johnson, E. R., Powers, S. I., Spangler,L. Et. Al. 1, 2012, American Journal of Epidemiology, Vol. 176, pp. 1-13.
7. Vitamin D as potential antidepressant in outpatients with musculoskeltal pain. Abdul-Razzak, K.K, Mayyas, F.A., Al-Farras, M.I. s.l. : Int. Jounral of Clinical Pharmacology and Therapeutics, 2018, Vol. 56, pp. 400-410.
8. The Role of Vitamin D in Brain Health: A Mini Lierature Review. Anjum, I., Jaffery, S., Fyyaz, M., et al. 7, s.l. : Cureus, 2018, Vol. 10.
AMERICAN COLONIES AND BRITAIN RECONCILIATION
AMERICAN COLONIES AND BRITAIN RECONCILIATION
Students Name
Instructor
Department Of Affiliation
Course
Date
Reconciliation between American colonies and Great Britain
There was no likelihood of reconciliation between American colonies and Great Britain because of several reasons like; the British government had huge debts .this was right after the French and India war .to cover these debts the British government-imposed taxes on the colonies like the stamp act which declared that all Americans colonists were equal to all British citizens and the parliament could not tax the colonists if there was no colonial representation in the parliament (Morgan, & Morgan, 1953). This annoyed the Americans because it was simply a way to extort money from the American colonies so that the British could pay their debts and be able to provide their army with weapons. Also, the Boston tea party where the Americans boarded a British ship and destroyed British tea worth millions in protest of the tea party (Dickinson, 2010). The British responded by closing all of Boston’s harbors until all the tea was paid for, there was increased power of the military governor. After this reconciliation seemed impossible.
The stamp act policy was an example of taxation without representation and they found out that the person who was supposed to fight for their rights was working to limit them .the colonists were not consulted before it was passed and they felt it was a gateway for more taxation schemes and the money collected was used for matters that were beyond colonial legislation. All printed work required a stamp which was supposed to be purchased from an authorized stamp distributor.
The stamp act brought a lot of disagreements between the American colonies and the British government as the colonists felt it was too much and they boycotted the British goods and they rioted. They also attacked and threatened the tax collectors and the stamp distributors which led to most of them resigning (Jensen, 1940). The colonists were not consulted and there was no one to represent them during the enactment. The American colonies felt that the British had no right to tax them. The tax money was to pay for the British’s debts and to get more weapons for their army. This angered the American colonies as they were being used and it led to rioting
References
Dickinson, H. T. (2010). the Failure of conciliation: Britain and the American colonies 1763–1783. The Kyoto economic review, 79(2), 91-109.
Morgan, E. S., & Morgan, H. M. (1953). The Stamp Act Crisis: Prologue to Revolution. UNC Press Books.
Jensen, M. (1940). The Articles of Confederation: An Interpretation of the social-constitutional history of the American Revolution, 1774-1781. Univ of Wisconsin Press.
American civilization traits
American civilization traits
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Instructor
Subject
Date
American civilization traits entail the unique cultural identity that Americans possess. These traits transcend all the divisions within ethnic, racial, religious, political and other spheres of Americans. These are personality and sense of character that Americans share as a community. These traits find their roots from the colonial era. Some of the quintessential traits that American civilization population has are independence, hard work, inventiveness, ambition, risk taking, commitment and honest characters. (Hale, 1835).
Americans are self-defined and self-made, and one specific character that is evident with their society is their sense of independence. Americans are personal, independent citizens. They have a sense of live free or die, and the trait of personal independence has enabled Americans protect and maintain their political system. From time immemorial, Americans have always embraced independence and rejected the federal influence. Americans are also hard working citizens, and they strongly believe in the fruits of one’s labor. Other societies might see this as selfishness, but this is what has enabled the Americans to develop over time. They are committed in what they do and passionately perform to the fullest of their capability. From colonial eras, Americans have always embraced hard work (Hale, 1835).
Americans are also inventive in that they conceptualize brilliant ideas that shape the society in a positive way and solve the problems of the society. For example, Microsoft, the invention by Bill Gates an American citizen who made the first personal computer and invented the Internet. This invention has changed the way people communicate and it has made communication easy. It has virtually changed the whole world. Americans are ambitious and risk takers, and they will do anything to get work done. All these traits have a positive attribute in the American society because they instill a sense of hard work, commitment and a sense of individualism at heart (John, 2007).
Reference
Hale Sarah Josepha Buell. (1835). Traits of American life. New York: E.L. Carey & Hart publishers.John P. (2007). Eight American Cultural Traits. Retrieved on November 28 2011 from >http://rationalamerican.com/defined<