Acute effects of nitrate and breakfast on working memory, cerebral blood flow, arterial stiffness, and psychological factors in adolescents: Study protocol for a randomised crossover trial.

BACKGROUND: Inorganic nitrate has been shown to acutely improve working memory in adults, potentially by altering cerebral and peripheral vasculature. However, this remains unknown in adolescents. Furthermore, breakfast is important for overall health and psychological well-being. Therefore, this study will investigate the acute effects of nitrate and breakfast on working memory performance, task-related cerebral blood flow (CBF), arterial stiffness, and psychological outcomes in Swedish adolescents. METHODS: This randomised crossover trial will recruit at least 43 adolescents (13-15 years old). There will be three experimental breakfast conditions: (1) none, (2) low-nitrate (normal breakfast), and (3) high-nitrate (concentrated beetroot juice with normal breakfast). Working memory (n-back tests), CBF (task-related changes in oxygenated and deoxygenated haemoglobin in the prefrontal cortex), and arterial stiffness (pulse wave velocity and augmentation index) will be measured twice, immediately after breakfast and 130 min later. Measures of psychological factors and salivary nitrate/nitrite will be assessed once before the conditions and at two-time points after the conditions. DISCUSSION: This study will provide insight into the acute effects of nitrate and breakfast on working memory in adolescents and to what extent any such effects can be explained by changes in CBF. This study will also shed light upon whether oral intake of nitrate may acutely improve arterial stiffness and psychological well-being, in adolescents. Consequently, results will indicate if nitrate intake from beetroot juice or if breakfast itself could acutely improve cognitive, vascular, and psychological health in adolescents, which can affect academic performance and have implications for policies regarding school meals. TRIAL REGISTRATION: The trial has been prospectively registered on 21/02/2022 at https://doi.org/10.1186/ISRCTN16596056. Trial number: ISRCTN16596056.

Training fast or slow? Exercise for depression: A randomized controlled trial.

Exercise can be used to treat depression but there is a lack of evidence regarding the optimal intensity and mode. Our aim was to compare the effects of different exercise intensities on post-treatment depression severity. People aged 18-67years with mild to moderate depression (Patient Health Questionnaire-9 score of ≥10) participated in a single-blind, parallel randomized control trial lasting 12-weeks (Sweden 2011-2013). Four treatment arms were included: treatment as usual (TAU) (n=310), light exercise (yoga or similar n=106), moderate exercise (aerobic conditioning, n=105) and vigorous exercise (aerobic conditioning, n=99). Depression severity was measured at baseline and post-treatment using the Montgomery-Åsberg Depression Rating Scale (MADRS). Differences between the groups in depression severity at post-treatment were analysed using linear regression. Differences in exercise intensity were confirmed by heart rate monitoring. At post-treatment, the light (-4.05 Confidence Interval (CI)=-5.94, -2.17), moderate (-2.08 CI=-3.98, -0.18) and vigorous exercise groups (-3.13 CI=-5.07, -1.19) had reduced their MADRS scores significantly more than TAU. No significant differences were found between the exercise groups, and no significant interaction effect was observed between group and gender. In conclusion, exercise, whether performed at a low (yoga or similar), moderate or vigorous intensity (aerobic training) is effective in treating mild to moderate depression and is at least as effective as treatment as usual by a physician.

[Utilization of complimentary and alternative health services in Iceland]. / Notkun óhefdbundinnar heilbrigdisþjónustu á Íslandi.

OBJECTIVE: Westerners increasingly use complimentary and alternative (CAM) methods for curing illness and promoting health. The central ideas of CAM appear to resonate with large segments of the general public. Little is known about CAM use in Iceland. The purpose of the study was to assess the scope of utilization of CAM providers and the likely explanatory factors. MATERIAL AND METHODS: The data come from a national postal health survey that took place during the Fall of 2006. A sample of Icelandic adults, age 18-75, was randomly drawn from the National Register. 1532 individuals responded to the survey yielding a 60% response rate. RESULTS: Almost 32% of the respondents had used a CAM provider in the past 12 months, an estimated increase of 6% since 1998. Women and high income individuals were more likely to use a CAM provider than men and lower income individuals. Physical and mental distress was also related to the likelihood of CAM use. Individuals having negative or positive attitude toward physician services were more likely to use a CAM provider than those expressing a neutral attitude. Finally, repeated physician visits were related to an increased likelihood of CAM use. CONCLUSIONS: Icelanders use CAM providers to a considerable degree, and CAM use has increased in recent years. It appears that some clients regard the care they receive in the general health system as insufficient. Most CAM users appear to use CAM treatments as a supplement to the care received in the general health system.