Depression Counseling reduces cancer inflammation

This small study has found some connections between treating depression and reduction of inflammation, a condition known to have a promoting impact on cancers and a negative effect on health in general. Nice piece of body-mind connection science! JD

A Psychological Intervention Reduces Inflammatory Markers by Alleviating Depressive Symptoms: Secondary Analysis of a Randomized Controlled Trial Lisa M. Thornton , PhD, Barbara L. Andersen , PhD, Tammy A. Schuler , MA, William E. Carson III, MD

Address correspondence and reprint requests to: Lisa M. Thornton, PhD, E-mail: thornton.84@osu.edu.

Abstract

Objectives: To test experimentally whether a psychological intervention reduces depression-related symptoms and markers of inflammation among cancer patients and to test one mechanism for the intervention effects. Depression and inflammation are common among cancer patients. Data suggest that inflammation can contribute to depressive symptoms, although the converse remains untested. Methods: As part of a randomized clinical trial, newly diagnosed breast cancer patients (n = 45) with clinically significant depressive symptoms were evaluated and randomized to psychological intervention with assessment or assessment only study arms. The intervention spanned 12 months, with assessments at baseline, 4, 8, and 12 months. Mixed-effects modeling tested the hypothesis that the intervention reduced self-reported depressive symptoms (Center for Epidemiological Studies Depression scale, Profile of Mood States Depression and Fatigue subscales, and Medical Outcomes Study-Short Form 36 Bodily Pain subscale) and immune cell numbers that are elevated in the presence of inflammation (white blood cell count, neutrophil count, and helper/suppressor ratio). Mediation analyses tested whether change in depressive symptoms, pain, or fatigue predicted change in white blood cell count, neutrophil count, or the helper/suppressor ratio. Results: The intervention reduced significantly depressive symptoms, pain, fatigue, and inflammation markers. Moreover, the intervention effect on inflammation was mediated by its effect on depressive symptoms. Conclusions: This is the first experiment to test whether psychological treatment effective in reducing depressive symptoms would also reduce indicators of inflammation. Data show that the intervention reduced directly depressive symptoms and reduced indirectly inflammation. Psychological treatment may treat effectively depressive symptoms, pain, and fatigue among cancer patients.

Published online before print July 21, 2009
Psychosom Med 2009, doi:10.1097/PSY.0b013e3181b0545c

© 2009 by American Psychosomatic Society

Anti-inflammatory diets and IF Ratings

I was poking around nutritiondata.com today and discovered they include a box called an IF, or, Inflammation Factor Rating for foods. I found the concept and following explanation fascinating. The addition of this data along with a remarkable selection of nutrition facts makes this a very useful and user friendly website, worth reviewing as health and diet questions arise.

Among the many things they quantify for each food is its Nutrition Facts (just like the label on packaged foods); Glycemic Load, caloric ratio of carbs/fats/proteins, fullness factor, ratings for optimal weight loss or weight gain, nutrient balance and amino acid graphs, complete detailed nutrient breakdown of vitamins, minerals, fats, aminos, calories, carbs, fiber, and sterols.

There are lots of other useful tools on the site as well, so check it out! Today, I was curious about the nutritional value of rhubarb, a great early summer "vegetable" that cooks up so tasty in pies and compote. To maintain the low glycemic rating I sweetened it with agave syrup, and thickened it with arrowroot powder (no corn!). Be Well, Janis

The website includes the following "About" comments:
Nutrition Data's continuing goal is to provide the most accurate and comprehensive nutrition analysis available, and to make it accessible and understandable to all.

The information in Nutrition Data's database comes from the USDA's National Nutrient Database for Standard Reference and is supplemented by listings provided by restaurants and food manufacturers. The source for each individual food item is listed in the footnotes of that food's analysis page. In addition to food composition data, Nutrition Data also provides a variety of proprietary tools to analyze and interpret that data. These interpretations represent Nutrition Data's opinion and are based on calculations derived from Daily Reference Values (DRVs), Reference Daily Intakes (RDIs), published research, and recommendations of the FDA.

May 19, 2008 Lots of questions about anti-inflammatory diets and IF Ratings

If you've been following the health news for the past couple of years, you've probably tuned into the fact that many experts (including Andrew Weil, Barry Sears, Nicholas Perricone, Leo Galland, and yours truly) recommend an anti-inflammatory diet as a way to forestall aging and disease. For the benefit of those interested in this aspect of nutrition, Nutrition Data displays the IF (Inflammation Factor) Rating of foods and recipes as part of the detailed nutrition analysis.

Over the past few weeks, I've gotten a lot of questions about the IF Ratings of various foods. For example:

Q. Whole grains are supposed to be good for you and have an overall anti-inflammatory effect on the body, but your data on, e.g., barley and oats, indicates a high inflammatory effect. Could you please explain this?

Q. Why is the IF Rating for farmed salmon (-421) so much lower then the rating for wild salmon (+901). Both are salmon. Why there is such a big difference in the IF?

Q. I don't understand why walnuts have a negative IF Rating. I've heard that they are anti-inflammatory because they are high in omega-3 fats.

Q. Can you explain why an apple would be considered an inflammatory food?

First, a bit of background on how the IF Ratings (and I) came to be part of ND:

I developed the IF Rating system in 2005, as a way to estimate the inflammatory and anti-inflammatory potential of foods and combinations of foods. In 2006, I published The Inflammation Free Diet Plan, a book in which I detailed how the IF Rating system is calculated and how to use it. After the book and the IF Ratings were published, NutritionData.com (with my permission) added the IF Ratings to the site as part of its food and recipe analysis. Subsequently, I was invited to be a nutrition advisor for ND.

Even before I become a member of the ND team, I was delighted to make the IF Ratings available as part of NutritionData's analysis. However, one downside of making the ratings more widely available is that they now appear without the explanatory information included in the book. All of the above questions, for example, are addressed in The Inflammation Free Diet Plan.

Let me try to clear up a few of the most common misunderstandings:

Perhaps the most common misunderstanding is that all “healthy” foods are anti-inflammatory and all “unhealthy” foods are inflammatory. It’s a little more complex than that. The IF Rating system evaluates foods according to over 20 nutritional factors, including antioxidants, fatty acid composition, glycemic load, and many other nutrients. Often a food or meal will have a combination of pro- and anti-inflammatory factors of varying strengths, and the IF Rating is able to estimate the net effect of all these factors.

As you can see from the questions above, the IF Ratings often reveal some things that don’t line up with the conventional wisdom. Nonetheless, the ratings are based entirely on the actual nutritional composition of the foods and a little investigation always reveals an objective basis for “surprising” information.

The devil is in the (nutritional) details

In the case of whole grains, they do contain some anti-inflammatory nutrients, in particular zinc and folate. But they also contain a lot of carbohydrates, which tend to increase blood sugar, which tends to exacerbate inflammation. Likewise, the biggest contributor to the IF Rating of apples is the glycemic load, which, while not large, is still measurable. The net effect is a negative rating.

With salmon, it depends on what kind of salmon you’re talking about. Wild salmon is strongly anti-inflammatory, due in large part to its high levels of EPA and DHA, two strongly anti-inflammatory omega-3 fats. Farmed salmon, which is the majority of what is commercially sold, is also high in EPA and DHA. What most people don’t realize is that farmed salmon is also extremely high in arachidonic acid, which is the most inflammatory of the omega-6 fatty acids. This is because farmed salmon eat an artificial diet that is enriched with vegetable oils.

Not surprisingly, the difference in the diet makes a big difference in the nutritional composition of the fish. Like us, salmon are what they eat. So in farmed salmon, the anti-inflammatory benefits of the EPA and DHA are completely overwhelmed by the inflammatory capacity of the arachidonic acid. This is a critical distinction that is completely overlooked in most lists of “anti-inflammatory foods."

And finally, walnuts have a reputation for being anti-inflammatory because they are a good source of omega-3 fatty acids. While this is true, what people often overlook is that walnuts are even higher in omega-6 fatty acids. Research shows that a high ratio of omega-6 to omega-3 fats in the diet promotes inflammation. While eating walnuts increases your intake of omega-3 fats, it increases your intake of omega-6 fats even faster. Although walnuts can be a great part of a healthy, anti-inflammatory diet, eating walnuts alone will not improve the omega-6/omega-3 ratio of your diet.

Foods with negative IF Ratings are not necessarily bad for you!

As I explain in my book, the goal is not necessary to avoid all negatively-rated foods but to bring the diet into balance. Many foods with slightly negative IF Ratings, such as apples, walnuts, and whole grains, are quite healthful. In fact, it would be impossible to build a balanced diet without including foods that have negative IF Ratings.

Keep in mind that inflammation is a healthy and necessary part of the human immune response; so it makes sense that a healthy diet would include factors that support the inflammatory response. The problem is an excessive inflammatory response, driven by an excess of foods that promote inflammatory pathways.

While I believe it's wise to limit or avoid foods that are strongly inflammatory, such as french fries or farmed salmon, there's no reason to avoid wholesome foods like fruits and grains. Just aim to have the sum of all foods eaten in a day to have a positive IF Rating, so that the overall effect of the diet is anti-inflammatory.

I hope that clears up some of the confusion! You'll find answers to more frequently asked questions about the IF Rating system on my author's blog on Amazon.com as well as the book's website Inflammation Factor.com.

Posted by Monica Reinagel 1:35:20 PM

Possible link between inflammation and bipolar disorder

Body and Brain
Tina Hesman Saey

Bipolar disorder scrawls a molecular John Hancock across the brains of some people. The signature is sometimes visible even before symptoms start, researchers in the Netherlands report.

A team led by Hemmo Drexhage, a clinical immunologist at Erasmus Medical Center in Rotterdam, found that certain white blood cells, called monocytes, pump up activity of various genes in people who have bipolar disorder. Many of the genes are involved in inflammation as well as cell movement, cell death or survival, and a pathway that allows cells to respond to chemicals that promote cell growth.

The signature of elevated gene activity in monocytes could help diagnose and classify bipolar disorder and other psychiatric disorders. Published in the April issue of Archives of General Psychiatry, the discovery also suggests that anti-inflammatory drugs could help treat the disorders.

Monocytes and other white blood cells called macrophages help fight infections and clean up dead and dying cells from injury sites.

"Everywhere in your body you have these cells, but they're not just lying around waiting for bugs to come around," Drexhage says.

The cells are involved in inducing fever. They also play an important role in the brain. They are some of the cells that make up the microglia, which are support cells for neurons. Microglial cells help regulate the brain's chemical communication system, as well as neuron growth and the formation of connections between neurons.

Drexhage became interested in the link between inflammation and psychiatric illnesses when he learned that people with bipolar disorder have a three times greater than average chance of developing autoimmune thyroid disease, an inflammatory disorder. Other data suggest that the risk for type I diabetes and some other inflammatory diseases may also be elevated in people with psychiatric disease.

"It's not just a disease of the brain, it affects the entire system," Drexhage says.

His team isolated monocytes from mentally healthy people and from people with bipolar disorder. Activity levels of 19 genes were altered in people with bipolar disorder. Twenty-three of 42 people (55 percent) with bipolar disorder carried the signature alterations, while only seven of 38 healthy people (18 percent) did.

Children of bipolar patients also bore the disorder's signature more often than did offspring of healthy people, even before symptoms of the disorder were apparent. During the course of the study, three of the children of people with bipolar disorder developed depression. All of them carried the bipolar signature in their monocytes before they developed the illness. The bipolar markers were also found in 85 percent of the children who already had mood disorders when the study started, compared with 45 percent of children without mood disorders. Only 19 percent of the offspring of healthy parents carried the signature.

Lithium, a drug commonly used to treat bipolar disorder, brought activity levels of inflammatory genes down. But that's probably not the only effect the drug has on the brain, says Robert Yolken, director of the Stanley Neurovirology Laboratory at Johns Hopkins School of Medicine in Baltimore. Researchers need to develop a better picture of how the activity of inflammatory genes varies among the population before the signature recognized in the Dutch study can be used for widespread screening and diagnosis, Yolken says.
If you have a comment on this article that you would like considered for publication in Science News, send it to editors@sciencenews.org. Please include your name and location.

References:
Padmos, R.C. . . . and H.A. Drexhage. 2008. A discriminating messenger RNA signature for bipolar disorder formed by an aberrant expression of inflammatory genes in monocytes. Archives of General Psychiatry 65(April):395–407. Abstract available at http://archpsyc.ama-assn.org/cgi/content/abstract/65/4/395.

Sources:
Hemmo A. Drexhage
Department of Immunology
Erasmus Medical Center
P.O. Box 1738
3000 DR Rotterdam
Netherlands

Robert H. Yolken
Stanley Neurovirology Lab
Johns Hopkins University
600 North Wolfe Street
Baltimore, MD 21207
Web site: http://www.stanleylab.org

http://www.sciencenews.org/articles/20080412/fob3.asp

From Science News, Vol. 173, No. 15, April 12, 2008, p. 228.