Psychological and Psychiatric Research
Needs to Include Nutritional Assessment

 

    Nutrients, lack or excesses, can affect one's mental state.1

 

    Many individuals in the general population and in the psychological and psychiatric treatment populations do not eat nutritionally adequate diets.

    Individuals may or not take supplements, supplements may be multi-nutrient or single nutrient, may be at a high, moderate, or low levels. An individual's needs, absorption, and metabolism may be efficient or not, and effect their nutritional status.

 

   Individuals who participate in research in psychology and psychiatry are often assumed to be of uniform status - either as the control group or the group that is being observed for effect or changes due to a treatment, assessment, etc.2

 

   If not of uniform nutritional status, this could introduce bias into the conclusions of a research study. 3







 

   Unless nutritional status is affirmed in some way, the assumption of uniformity, vital to statistical decision-making, cannot truly be made.

     Assessment of reported diet intake is often not a reliable indication of nutritional status. Reports are often not accurate; foods eaten often do not correlate with biochemical status.

    Reported diet intake has been linked in some literature to biochemical levels of some nutrients.

    An assessment of diet could be a triage point for preliminary

establishment of uniformity of a research population.

     A nutrition-focused physical examination and observation of physical effects of nutrient excess or inadequacy would illustrate long term effects of altered nutritional status. 4, 5

    Psychological and/or mental changes will frequently occur such before physical change is observed. 6

    Such examination could serve as a secondary level of assessment for assumption of equality between individuals for research purposes.

 

     Biochemical laboratory assessment of nutritional status would be a conclusive step in establishing uniformity of nutritional status and an assumption of no difference for comparing populations under investigation.

Biochemical laboratory assessment might include

    Serum or plasma levels

    Blood component assessment (erythrocytes, leukocytes, etc)

    Functional assessment (nutrient-dependent enzyme activity, etc)

    Different forms of a nutrient (ionized, etc)

    Other measures.

 

   Research findings may well be affected by the nutritional status of the participants. To reduce the chance of variation in nutritional status affecting conclusions of the research, a measure of nutritional status needs to be integrated into studies of psychological and psychiatric phenomena.

References


1 Nutritional Status affects mental status:

Bottiglieri, Teodoro, Malcom Laundry, Richard Crellin, Brian K. Toone, Michail W.P. Carney, and Edward H. Reynolds. ‘Homoscysteine, folate, methylation and monoamine metabolism in depression.’ Journal of Neurology, Neurosurgery and Psychiatry 69 (2000):228-232.

 

Cohen, Jennifer H., Akan R. Kristal, Dianne Neumark-Sztainer, Cheryl L. Rock, and Marian L. Neuhouser. ‘Psychological distress associated with unhealthful dietary practices.’ Journal of the American DieteticAssociation 102(5) 2002):699-703.

Davidson, Jonathan R.T., Kurian Abraham, Kathryn M. Connor, and Malcolm N.McLeod. ‘Effectiveness of Chromium in Atypical Depression: A placebo-controlled trial.’ Biological Psychiatry 53 (2003):261-264.

 

Freeman, Marlene P., Joseph R. Hibbeln, Katherine L. Wisner, John M. Davis, David Mischoulon, Malcolm Peet, Paul E. Keck Jr, Laurne B. Marangell, Alexandra J. Richardson, James Lake, and Andrew Stoll. ‘Omega-3 fatty acids: Evidence basis for treatment and future research in psychiatry’. Journal of Clinical Psychiatry 67(12) (2006):1954-1967

 

Haller, Jurg. ‘Vitamins and Brain Function.’ In Nutritional Neuroscience. Edited by Harris R. Lieberman, Robin B. Kanarek, and Chandan Prasad, 229. Boca Raton, FL: CRC Press: Taylor & Francis Group, 2005.

 

Keys, Ancel, Josef Brozek, Austin Henschel, Olaf Mickelsen, and Henry Longstreet Taylor. The Biology

of Human Starvation, Minneapolis: University of Minnesota Press, 1950, 767-905.

 

Leyse-Wallace, Ruth. Linking Nutrition and Mental Health: A Scientific Exploration . iUniverse, Inc. Bloomington , IL, 2008.

 

Madan, A.K., W.S. Orth, D.S. Toichansky, and C.A. Ternovits. ‘Vitamin and Trace Mineral Levels After Laparoscopic Gastric Bypass.’ Obesity Surgery 16(5) (2006): 603-606.

 

Polivy, Janet. ‘Psychological consequences of food restriction.’ Journal of the American Dietetic Association 96(6) (1996):589-592.

 

2 Types of Evidence

 

U.S. Department of Health and Human Services (DHHS), Agency for Healthcare Research and Quality (AHRQ. http://www.ahrq.gov/clinic/epcsums/strengthsum.htm

 

3  Association and Bias

 

Hulley, Stephen B. and Steven R. Cummings. Designing Clinical Research . Philadelphia: Williams and Wilkins,1988.

 

4 Strumia, Renata. ‘Dermatologic signs in patients with eating disorders.’ American Journal of Clinical Dermatology 6(3) (2005):165-173.

5 Phillipp, Elisabeth, Karl-Martin Pirke, Martin Seidl, Reinhard J. Tuschl, Manfred M. Fichter, Mathias Eckert, and Gunther Wolfram. ‘Vitamin status in patients with anorexia nervosa and bulimia nervosa.’ International Journal of Eating Disorders 8(2) (1988):209-218.

 

6 Arroyave, Guillermo. ‘Sequence of events in the development of clinically evident nutritional disease.’ Figure 2 in Young, Vernon R. and Scrimshaw, Nevin S. ‘Genetic and Biologic Variability in Human Nutrient Requirement.’ American Journal of Clinical Nutrition 32 (1979):486-500.

 

©Ruth Leyse-Wallace PhD, RD
7-13-09; Alpine, CA 91901

Theory of PsychoNutriologic Person: Nutritional status and mental health / mental illness are inter-related in ways that can be
assessed and treated for improvement of health and quality of life.