RESUMO
OBJECTIVES: Although safe approaches for improving depression in pregnancy are required and the efficacy of omega-3 polyunsaturated fatty acids (PUFAs) has been suggested, the amount of supplemental omega-3 PUFAs has varied among previous studies and adequate amount might be different among countries. The aim of this pilot study is to explore the feasibility of using 1800â mg of omega-3 PUFAs supplementation for our future double-blind, placebo-control trial, and to clarify the clinical difference and the similarity between two sites of Japan and Taiwan. METHODS: Pregnant women between 12 and 24 weeks' gestation with depressive symptoms were recruited. Participants were supplemented daily with omega-3 PUFAs capsules containing 1206â mg eicosapentaenoic acid and 609â mg docosahexaenoic acid for 12 weeks. The primary outcome was change in total score on the 17-item Hamilton Rating Scale for Depression (HAMD) at 12 weeks after supplementation. RESULTS: Eight pregnant women in Japan and five in Taiwan participated in the study. A substantial proportion of pregnant women reported high consumption of omega-3 supplements and dietary fish were excluded in Taiwan rather than in Japan sites. The decrease in HAMD score from baseline to 12 weeks after the start of the intervention was significantly larger in Japanese participants than in Taiwanese participants (Wilcoxon rank sum test; Pâ =â 0.045). DISCUSSION: The improvement of depressive symptoms was smaller at the Taiwan site than at the Japan site. Differences in psychopathology of recruited participants identified by self-rating scales might affect the degree of population heterogeneity and the treatment efficacy. A randomized-controlled trial is needed to confirm these findings. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01948596.
Assuntos
Depressão/tratamento farmacológico , Suplementos Nutricionais , Ácidos Graxos Ômega-3/administração & dosagem , Gravidez , Adulto , Ácidos Docosa-Hexaenoicos/administração & dosagem , Ácido Eicosapentaenoico/administração & dosagem , Estudos de Viabilidade , Feminino , Humanos , Japão , Projetos Piloto , Estudos Prospectivos , Taiwan , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVE: To investigate the effect of olfactory stimulation with essential oils on cardiovascular reactivity during the "moving beans" rehabilitation task in stroke patients with anxiety. METHODS: Twenty-eight stroke patients participated in this study. Blood pressure and heart rate were measured before and after finger movement tasks (e.g., moving beans and the Purdue pegboard test). Olfactory stimulation with lavender oil, grapefruit oil, and distilled water were conducted during finger tasks. Anxiety was assessed using the State Trait Anxiety Inventory (STAI)-Y2 before the finger movement tasks. RESULTS: There were no significant changes in blood pressure or heart rate activity in both finger movement tasks when stimulation of lavender oil, grapefruit oil, and distilled water was applied. However, the change values of Δ diastolic blood pressure (DBP) associated with the moving beans task indicated a significant interaction between olfactory stimulations and the groups of STAI-Y2 scores (high vs low) (p=0.03), without main effects in the olfactory stimulations and the groups of STAI-Y2 scores. CONCLUSION: Olfactory stimulation with lavender and grapefruit oil may repress the exaggerated DBP response during the moving beans task in stroke patients with higher levels of trait anxiety symptoms.
Assuntos
Ansiedade/tratamento farmacológico , Pressão Sanguínea/efeitos dos fármacos , Terapia Ocupacional , Óleos Voláteis , Óleos de Plantas , Reabilitação do Acidente Vascular Cerebral , Frequência Cardíaca/efeitos dos fármacos , Humanos , Lavandula , Terapia Ocupacional/métodos , Terapia Ocupacional/estatística & dados numéricos , Óleos Voláteis/farmacologia , Óleos Voláteis/uso terapêutico , Óleos de Plantas/farmacologia , Óleos de Plantas/uso terapêutico , Reabilitação do Acidente Vascular Cerebral/métodos , Reabilitação do Acidente Vascular Cerebral/estatística & dados numéricosRESUMO
BACKGROUND: Maternal depression can be harmful to both mothers and their children. Omega-3 polyunsaturated fatty acid (PUFA) supplementation has been investigated as an alternative intervention for pregnant women with depressive symptoms because of the supporting evidence from clinical trials in major depression, the safety advantage, and its anti-inflammatory and neuroplasticity effects. This study examines the efficacy of omega-3 PUFA supplementation for pregnant women with depressive symptoms in Taiwan and Japan, to provide evidence available for Asia. The rationale and protocol of this trial are reported here. METHODS: The Synchronized Trial on Expectant Mothers with Depressive Symptoms by Omega-3 PUFAs (SYNCHRO) is a multicenter, double-blind, parallel group, randomized controlled trial. Participants will be randomized to either the omega-3 PUFAs arm (1,200 mg eicosapentaenoic acid and 600 mg docosahexaenoic acid daily) or placebo arm. Primary outcome is total score on the Hamilton Rating Scale for Depression (HAMD) at 12 weeks after the start of the intervention. We will randomize 56 participants to have 90 % power to detect a 4.7-point difference in mean HAMD scores with omega-3 PUFAs compared with placebo. Because seafood consumption varies across countries and this may have a major effect on the efficacy of omega-3 PUFA supplementation, 56 participants will be recruited at each site in Taiwan and Japan, for a total number of 112 participants. Secondary outcomes include depressive symptoms at 1 month after childbirth, diagnosis of major depressive disorder, changes in omega-3 PUFAs concentrations and levels of biomarkers at baseline and at 12 weeks' follow-up, and standard obstetric outcomes. Data analyses will be by intention to treat. The trial was started in June 2014 and is scheduled to end in February 2018. DISCUSSION: The trial is expected to provide evidence that can contribute to promoting mental health among mothers and children in Asian populations. TRIAL REGISTRATION: Clinicaltrials.gov: NCT02166424 . Registered 15 June 2014; University Hospital Medical Information Network (UMIN) Center: UMIN000017979. Registered 20 May 2015.
Assuntos
Transtorno Depressivo/terapia , Ácidos Graxos Ômega-3/uso terapêutico , Mães/psicologia , Complicações na Gravidez/tratamento farmacológico , Projetos de Pesquisa , Adulto , Criança , Transtorno Depressivo/psicologia , Suplementos Nutricionais , Método Duplo-Cego , Feminino , Humanos , Japão , Gravidez , Complicações na Gravidez/psicologia , Taiwan , Resultado do TratamentoAssuntos
Depressão/tratamento farmacológico , Suplementos Nutricionais , Ácidos Graxos Ômega-3/farmacologia , Avaliação de Resultados em Cuidados de Saúde , Complicações na Gravidez/tratamento farmacológico , Adulto , Ácidos Graxos Ômega-3/administração & dosagem , Feminino , Humanos , Japão , Projetos Piloto , Gravidez , TaiwanRESUMO
BACKGROUND: Previous studies have reported that green tea consumption is associated with a lower risk of diseases that cause functional disability, such as stroke, cognitive impairment, and osteoporosis. Although it is expected that green tea consumption would lower the risk of incident functional disability, this has never been investigated directly. OBJECTIVE: The objective was to determine the association between green tea consumption and incident functional disability in elderly individuals. DESIGN: We conducted a prospective cohort study in 13,988 Japanese individuals aged ≥65 y. Information on daily green tea consumption and other lifestyle factors was collected via questionnaire in 2006. Data on functional disability were retrieved from the public Long-term Care Insurance database, in which subjects were followed up for 3 y. We used Cox proportional hazards regression analysis to investigate the association between green tea consumption and functional disability. RESULTS: The 3-y incidence of functional disability was 9.4% (1316 cases). The multiple-adjusted HR (95% CI) of incident functional disability was 0.90 (0.77, 1.06) among respondents who consumed 1-2 cups green tea/d, 0.75 (0.64, 0.88) for those who consumed 3-4 cups/d, and 0.67 (0.57, 0.79) for those who consumed ≥5 cups/d in comparison with those who consumed <1 cup/d (P-trend < 0.001). CONCLUSION: Green tea consumption is significantly associated with a lower risk of incident functional disability, even after adjustment for possible confounding factors.
Assuntos
Bebidas , Transtornos Cognitivos/epidemiologia , Osteoporose/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Chá/química , Idoso , Idoso de 80 Anos ou mais , Povo Asiático , Índice de Massa Corporal , Transtornos Cognitivos/prevenção & controle , Ingestão de Energia , Feminino , Seguimentos , Humanos , Incidência , Japão/epidemiologia , Estilo de Vida , Masculino , Osteoporose/prevenção & controle , Estudos Prospectivos , Fatores de Risco , Acidente Vascular Cerebral/prevenção & controle , Inquéritos e QuestionáriosRESUMO
BACKGROUND: On March 11, 2011, a magnitude 9.0 earthquake, the most powerful ever recorded in Japan, and a massive tsunami struck off the coast of the Sanriku region. A Disaster Medical Assistance Team, a mobile medical team with specialized training that is deployed during the acute phase of a disaster, was dispatched to areas with large-scale destruction and multiple injured and sick casualties. Previous studies have reported critical incident stress (i.e. posttraumatic stress disorder symptoms and depressive symptoms) among rescue workers as well as the need for screening and prevention for posttraumatic stress disorder. So far we have shown in an open trial that posttraumatic stress disorder symptoms in critically injured patients can be reduced by taking omega-3 fatty acids intended to stimulate hippocampal neurogenesis. METHOD/DESIGN: This study is designed to determine the effectiveness of attenuating posttraumatic distress with omega-3 polyunsaturated fatty acids among Disaster Medical Assistance Team members after the Great East Japan Earthquake, and is named the APOP randomized controlled trial which is currently ongoing. First, we will provide psycho-education on posttraumatic distress, which is common in responders to the Disaster Medical Assistance Team members deployed to the disaster area. Second, observational research will be conducted to evaluate critical incident stress following the completion of medical activities. Third, team members who provide consent to participate in the intervention research will be randomly divided into a group given an omega-3 fatty acid supplement and a group not given the supplements. Outcome will be evaluated at 12 weeks after the supplements are shipped to the team members. DISCUSSION: Measures that address critical incident stress in disaster responders are important, but there is no substantial evidence that links such measures with prevention of posttraumatic stress disorder. Thus, any confirmation through this study that the intake of omega-3 fatty acid supplements serves as a simple preventative measure for critical incident stress will be of great significance. TRIAL REGISTRATION: UMIN Clinical Trials Registry, UMIN000005367.
Assuntos
Socorristas/psicologia , Ácidos Graxos Ômega-3/uso terapêutico , Transtornos de Estresse Pós-Traumáticos/dietoterapia , Adolescente , Adulto , Protocolos Clínicos , Suplementos Nutricionais , Desastres , Terremotos , Humanos , Japão , Educação de Pacientes como Assunto , Escalas de Graduação Psiquiátrica , Transtornos de Estresse Pós-Traumáticos/psicologiaRESUMO
OBJECTIVE: To examine the association between green tea consumption and tooth loss. METHODS: We analyzed cross-sectional data from the Ohsaki Cohort 2006 Study. Usable self-administered questionnaires about green tea consumption and tooth loss were returned from 25,078 persons (12,019 men and 13,059 women) aged 40 to 64 years in Japan. Multivariate logistic regression analysis was used to calculate odds ratios (ORs) for tooth loss using 3 cut-off points of 10, 20, and 25 teeth relative to each category of green tea consumption. RESULTS: Consumption of > or = 1 cup/day of green tea was significantly associated with decreased odds for tooth loss, and the association appeared to fit a threshold model. In men, the multivariate-adjusted ORs for tooth loss with a cut-off point of <20 teeth associated with different frequencies of green tea consumption were 1.00 (reference) for <1 cup/day, 0.82 (95% CI, 0.74-0.91) for 1-2 cups/day, 0.82 (95% CI, 0.73-0.92) for 3-4 cups/day, and 0.77 (95% CI, 0.66-0.89) for > or = 5 cups/day. The corresponding data for women and the results for cut-off points of 10 and 25 teeth were essentially the same. CONCLUSIONS: The present findings indicate an association of green tea consumption with decreased odds for tooth loss.
Assuntos
Catequina/farmacologia , Cárie Dentária/epidemiologia , Chá , Perda de Dente/epidemiologia , Adulto , Intervalos de Confiança , Estudos Transversais , Comportamento Alimentar , Feminino , Humanos , Japão/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Inquéritos Nutricionais , Razão de Chances , Fatores de Risco , AutoadministraçãoRESUMO
BACKGROUND: Although green tea or its constituents might reduce psychological stress, the relation between green tea consumption and psychological distress has not been investigated in a large-scale study. OBJECTIVE: Our aim was to clarify whether green tea consumption is associated with lower psychological distress. DESIGN: We analyzed cross-sectional data for 42,093 Japanese individuals aged > or =40 y from the general population. Information on daily green tea consumption, psychological distress as assessed by the Kessler 6-item psychological distress scale, and other lifestyle factors was collected by using a questionnaire. We used multiple logistic regression analyses adjusted for age, sex, history of disease, body mass index, cigarette smoking, alcohol consumption, time spent walking, dietary factors, social support, and participation in community activities to investigate the relation between green tea consumption and psychological distress. RESULTS: We classified 2774 (6.6%) of the respondents as having psychological distress (Kessler 6-item psychological distress scale > or =13/24). There was an inverse association between green tea consumption and psychological distress in a model adjusted for age and sex. Although the relation was largely attenuated when possible confounding factors were adjusted for, a statistically significant inverse association remained. The odds ratio (with 95% CI) of developing psychological distress among respondents who consumed >/=5 cups of green tea/d was 0.80 (0.70, 0.91) compared with those who consumed <1 cup/d. These relations persisted when respondents were stratified by social support subgroups or by activities in communities. CONCLUSION: Green tea consumption was inversely associated with psychological distress even after adjustment for possible confounding factors.
Assuntos
Estresse Psicológico/prevenção & controle , Chá/fisiologia , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Japão , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Razão de Chances , Estresse Psicológico/psicologia , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: To investigate the association between green tea consumption and liver cancer incidence. METHODS: We prospectively followed 41,761 Japanese adults aged 40-79 years, without a history of cancer at the baseline or any missing data for green tea consumption frequency. Cox proportional hazards models were used to calculate hazard ratios (HR) with 95% confidence intervals (CI), adjusted for age, alcohol drinking, smoking, the consumption of coffee, vegetables, dairy products, fruit, fish, and soybean. RESULTS: Over 9 years of follow-up, among 325,947 accrued person-years, the total incidence of liver cancer was 247 cases. We found that green tea consumption was inversely associated with the incidence of liver cancer. In men, the multivariate-adjusted HRs (95% CIs) for liver cancer incidence with different green tea consumption categories were 1.00 (reference) for <1 cup/day, 0.83 (0.53-1.30) for 1-2 cups/day, 1.11 (0.73-1.68) for 3-4 cups/day, and 0.63 (0.41-0.98) for >/=5 cups/day (p for trend = 0.11). The corresponding data among women were 1.00 (reference), 0.68 (0.35-1.31), 0.79 (0.44-1.44), 0.50 (0.27-0.90) (p for trend = 0.04). CONCLUSIONS: Green tea consumption is associated with a reduced risk of liver cancer incidence.
Assuntos
Carcinoma/etiologia , Comportamento de Ingestão de Líquido/fisiologia , Neoplasias Hepáticas/etiologia , Chá , Adulto , Idoso , Bebidas , Carcinoma/epidemiologia , Estudos de Coortes , Ingestão de Alimentos/fisiologia , Feminino , Humanos , Incidência , Japão/epidemiologia , Neoplasias Hepáticas/epidemiologia , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Fatores de RiscoRESUMO
Several biologic studies have reported that green tea constituents have antitumor effects on hematologic malignancies. However, the effects in humans are uncertain. The authors used data from the Ohsaki National Health Insurance Cohort Study in Japan to evaluate the association between green tea consumption and the risk of hematologic malignancies. Study participants were 41,761 Japanese adults aged 40-79 years without a history of cancer at baseline who answered a food frequency questionnaire survey in 1994. During 9 years of follow-up beginning in 1995, the authors documented 157 hematologic malignancies, including 119 cases of lymphoid neoplasms and 36 cases of myeloid neoplasms. Hazard ratios were calculated by using the Cox proportional hazards regression model. Risk of hematologic malignancies was inversely associated with green tea consumption. The multivariate-adjusted hazard ratio of hematologic malignancies for 5 cups/day or more compared with less than 1 cup/day of green tea was 0.58 (95% confidence interval: 0.37, 0.89). The corresponding risk estimate was 0.52 (95% confidence interval: 0.31, 0.87) for lymphoid neoplasms and 0.76 (95% confidence interval: 0.32, 1.78) for myeloid neoplasms. This inverse association was consistent across sex and body mass index strata. In conclusion, green tea consumption was associated with a lower risk of hematologic malignancies.
Assuntos
Catequina/administração & dosagem , Neoplasias Hematológicas/epidemiologia , Chá , Adulto , Idoso , Estudos de Coortes , Intervalos de Confiança , Feminino , Inquéritos Epidemiológicos , Neoplasias Hematológicas/prevenção & controle , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Modelos de Riscos Proporcionais , Estudos Prospectivos , Medição de Risco , Espanha , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Experimental and animal studies have shown the activities of catechins, the main constituents of green tea, against infectious agents. No data are available on the association between green tea consumption and the risk of pneumonia in humans. OBJECTIVE: We examined the association between green tea consumption and death from pneumonia in humans. DESIGN: We conducted a population-based cohort study, with follow-up from 1995 to 2006. The participants were National Health Insurance beneficiaries in Japan (19,079 men and 21,493 women aged 40-79 y). We excluded participants for whom data on green tea consumption frequency were missing or who had reported a history of cancer, myocardial infarction, stroke, and extreme daily energy intake at baseline. We used Cox proportional hazards regression analysis to calculate hazard ratios (HRs) and their 95% CIs for death from pneumonia according to green tea consumption. RESULTS: Over 12 y of follow-up, we documented 406 deaths from pneumonia. In women, the multivariate HRs of death from pneumonia that were associated with different frequencies of green tea consumption were 1.00 (reference) for <1 cup/d, 0.59 (95% CI: 0.36, 0.98) for 1-2 cups/d, 0.55 (95% CI: 0.33, 0.91) for 3-4 cups/d, and 0.53 (95% CI: 0.33, 0.83) for > or =5 cups/d, respectively (P for trend: 0.008). In men, no significant association was observed. CONCLUSION: Green tea consumption was associated with a lower risk of death from pneumonia in Japanese women.
Assuntos
Camellia sinensis , Catequina/administração & dosagem , Extratos Vegetais/administração & dosagem , Pneumonia/mortalidade , Chá , Idoso , Estudos de Coortes , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Pneumonia/prevenção & controle , Modelos de Riscos Proporcionais , Fatores SexuaisRESUMO
An inverse association between coffee consumption and the risk of oral, pharyngeal, and esophageal cancers has been suggested in case-control studies, but few results from prospective studies are available. Data from the Miyagi Cohort Study in Japan were used to clarify the association between coffee consumption and the risk of these cancers. Information about coffee consumption was obtained from self-administered food frequency questionnaires in 1990. Among 38,679 subjects aged 40-64 years with no previous history of cancer, 157 cases of oral, pharyngeal, and esophageal cancers were identified during 13.6 years of follow-up. Hazard ratios were estimated by the Cox proportional hazards regression model. The risk of oral, pharyngeal, and esophageal cancers was inversely associated with coffee consumption. The multivariate-adjusted hazard ratio of these cancers for > or =1 cups of coffee per day compared with no consumption was 0.51 (95% confidence interval: 0.33, 0.77). This inverse association was consistent regardless of sex and cancer site and was observed both for subjects who did not drink or smoke and for those who currently drank or smoked at baseline. In conclusion, coffee consumption was associated with a lower risk of oral, pharyngeal, and esophageal cancers, even in the group at high risk of these cancers.
Assuntos
Café/efeitos adversos , Neoplasias Esofágicas/epidemiologia , Neoplasias Bucais/epidemiologia , Neoplasias Faríngeas/epidemiologia , Adulto , Intervalos de Confiança , Neoplasias Esofágicas/etiologia , Feminino , Seguimentos , Humanos , Incidência , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/etiologia , Neoplasias Faríngeas/etiologia , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Inquéritos e QuestionáriosRESUMO
The risk of suicide is well known to be increased among heavy alcohol drinkers. However, whether the risk is increased or decreased among light drinkers is still under debate. We investigated this association in a population-based sample of men in Japan. The Ohsaki Study was a population-based, prospective cohort study among Japanese adults aged from 40 to 79 years. Between October and December, 1994, 22,804 men in Miyagi Prefecture, Japan, completed a questionnaire on various health-related lifestyles, including alcohol drinking. During the subsequent 7 years follow-up, 73 participants committed suicide. We used the Cox proportional hazards regression model to estimate the hazard ratio (HR) for suicide mortality according to the quantity of alcohol consumed daily, with adjustment for potential confounders. There was a statistically significant positive and linear association between the amount of alcohol consumed and the risk of suicide: the multivariate HRs in reference to nondrinkers (95% confidence interval) were 1.2 (0.5-2.7), 1.5 (0.7-3.4), and 2.4 (1.2-4.6) in current drinkers who consumed =22.7g, 22.8g-45.5g, and >/=45.6g of alcohol per day, respectively (P-trend=.016). Even after the early death cases were excluded, a significant linear association was observed between alcohol consumption and the risk of suicide, with the risk of suicide also being nonsignificantly higher among the light drinkers than among nondrinkers (multivariate HR=1.7). This prospective cohort study indicated a positive linear association between alcohol consumption and the risk of suicide, and the suicide risk among the light drinkers was not decreased as compared with that in nondrinkers.