Vitamin B12 and Depression

Katie ColeHLSC 415 LabDecember 3rd, 2008

???Pop Quiz???

Which of the following foods contain Vitamin B12?

Breakfast cereals Tuna Milk Eggs Carrots

Overview of Presentation

1. Background information of Vitamin B122. Brief overview of depression3. Physiological Mechanism4. Two primary research articles in relation to

vitamin B12 and depression #1: Vitamin B12, folate, and homocysteine in

depression: The Rotterdam Study #2: Association between lifestyle factors and

mental health measures among community –dwelling older women

5. Concluding remarks

What is Vitamin B12?

Referred to as cobalamin (or Cyanocobalamin)

Synthesized by bacteria, fungi, and algae

Cows and sheep (rumen of stomach)

Closely related to Folate and Homocysteine levels in the body

Food and B12

Vitamin B12 comes from foods found in animals, they include the following:

Fish Beef Poultry Eggs Milk Milk products

RDA and UL B12

RDA FOR ADULTS AND CHILDREN

Age (years)

Male and Female (µg)

Pregnancy

1-3 .9 n/a

4-8 1.2 n/a

9-13 1.8 n/a

14-18 2.4 2.6

19 and older

2.4 2.6

UL FOR ADULTS AND CHILDREN

No toxicity associated with B12

No Upper level

Most children and Adults (U.S.) consume the recommended amounts of Vitamin B12

Functions of Vitamin B12

Helps to maintain nerve cells and red blood cells in human bodies.

Essential for DNA production, the genetic material found in all cells

Biochemical Processes

• B12 enters the stomach• HCL and Pepsin

Free B12 binds to R-Protein

Common Causes of B12 Deficiency

Absorption – Defective R- Protein Defect in binding of Intrinsic factor Absence of stomach or ileum Bacterial overgrowth of small intestine Tapeworm infestation Chronic malabsorption (AIDs)

Research Question

What is the Relationship between vitamin B12 and depression?

Depression

Very common yet serious illness

Affects men, women, and children of all ages around the world

Causes: combination of genetic, biochemical, environmental, and psychological factors.

Types of Depression

Major depressive disorder Dysthymic disorder (dysthymia)

Most common Psychotic depression Postpartum depression Seasonal effective disorder Bipolar disorder

Biochemical causes:

Inability to regulate uptake of neurotransmitters: Dopamine Serotonine Epinephrine Nor-epinephrine

These neurotransmitters are mood elevators

Physiological Mechanism

Vitamin B12 – One carbon metabolism

3 enzymes directly involved in Metabolism Methionine synthase Betaine homocysteine methyltransferase

One- Carbon Metabolism

http://herkules.oulu.fi/isbn9514270703/html/x305.html

Article #1 “Vitamin B12, folate, and homocysteine in depression: The Rotterdam Study

Participants age 55 and older Series of three surveys Addition of depression assessments in 3rd

survey Subjects who visited the research center

had blood taken. Of these subjects 278 had positive screening

results (symptoms)112 participants fulfilled the diagnostic

criteria for depression416 participants that had negative results

Article #1 “Design”

Case-control Study

278 people with depressive symptoms (case)

112 people with depressive disorder (case)

416 people with no signs or symptoms of depression (control)

Characteristic of interest: Vitamin b12, folate, and homocystein levels

statistics

DESCRIPTIVE

Mean Standard deviation

INFERENTIAL

Analysis of the variance (ANOVA)

Logistic regression Odds ratio 95% confidence

interval

Article #1

Article #1

STRENGTHS

Incorporation of diagnostic criteria

No selection bias Accounted for

confounding variables

WEAKNESSES

Subject bias (self reporting)

Population size

Results

Elderly people with vitamin B12 deficiency were more likely to have depressive disorders

Study suggests that vitamin B12 deficiency is independent of any confounding variables when being compared to participants with depressive disorders

Article #2 “Association between lifestyle factors and mental health measures among community-dwelling older women”

Women age 70 and older

Lifestyle variables assessed: Smoking, alcohol consumption, physical

activity, nutrition, and education. Depression, anxiety, quality of life,

cognitive function

Article #2 “Design”

Cross-sectional study

A group of people examined at one point in time

Women 70 years and older examined once, observing an association between lifestyle factors and cognitive abilities/depressive symptoms.

Statistics

DESCRIPTIVE

Mean Standard Deviation

(SD)

INFERENTIAL

t- test Pearson’s Spearman’s rho Logistic regression 95% Confidence

Intervals

Article #2

Article #2

STRENGTHS

In vivo Selection bias Confounding variables

WEAKNESSES

Interviewer bias Subject bias Population size

Results

B12 deficiency did not show any relation to depression

The results were most likely not accurate due to the population sample and a small percentage of participants having a b12 deficiency

B12 was also paired with folate levels

Conclusion

Article #1 was more accurate Other studies have shown similar

results

Future recommendations- Studies should include larger

population size More studies conducted on younger

population Focused on vitamin B12 and

depression

References

Cassidy, K., Kotynia-English, R., Acres, J., Flicker, L., Lautenschlager, N.T., & Almeida, O.P. (2004). Association between lifestyle factors and mental health measures among community dwelling older women. Australian and New Zealand Journal of Psychiatry. 38,940-947. Retrieved September 15, 2008 from Ebscohost database.

Penninx, B.W.J.H., Guralnik, J.M., Ferrucci, L., Fried, L.P., Allen, R.H., & Stabler, S.P. (2000). Vitamin deficiency and depression in physically disabled older women: epidemiologic from the women’s health and aging study. American Journal of Psychiatry. 157(5),715-721. Retrieved November 21, 2008, from Ebscohost.

Pinel, J.P.J. (2006) Biopsychology. (6th ed.). Toronto: Allyn and Bacon.

Tiemeier, H., Ruud van Tuijl, H., Hofman, A., Kiliaan, J.A., Breteler, M.M.B. (2002). Vitamin B12, folate, and homocysteine in depression: The Rotterdam Study. American Journal of Psychiatry,159(12), 2099-2101. Retrieved September 15, 2008, from Ebscohost database.

National Institutes of Health (2006). Dietary supplement fact sheet: vitamin B12. Retrieved November 21, 2008, from http://ods.od.nih.gov/factsheets/vitaminb12.asp#h1

Questions