Sources and bibliography

Easting stress and anxiety, and promoting calm

Hundreds of hours have been spent researching nutrition and self-care. These sources are normally included at the end of each book but they run to multiple pages. In the interest of saving the trees, reducing the weight of shipping, the online sources are listed here.

Invaluable books on nutrition

Blackburn, Elizabeth H, and Elissa Epel. The Telomere Effect: A Revolutionary Approach to Living Younger, Healthier, Longer. New York, Grand Central Publishing, 2018.

Calbom, Cherie, and John Calbom. Juicing, Fasting, and Detoxing for Life: Unleash the Healing Power of Fresh Juices and Cleansing Diets. New York, Grand Central Life & Style, 2014.

Caldwell B Esselstyn, Jr. Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure. New York, Avery, 2011.

Davis, Brenda, and Vesanto Melina. Becoming Raw: The Essential Guide to Raw Vegan Diets. Book Pub. Co, 2010.

Eleanor Noss Whitney. Understanding Nutrition. Australia, Cengage, 2019.

Fc & A Medical Publishing. Super Foods for Seniors. Peachtree City, Ga, Fc & A Medical Pub, 2008.

Fuhrman, Joel, and Robert B Phillips. Fast Food Genocide: How Processed Food Is Killing Us and What We Can Do about It. New York, Ny, Harperone, 2018.

Fuhrman, Joel. Super Immunity: The Essential Nutrition Guide for Boosting Your Body’s Defenses to Live Longer, Stronger, and Disease Free. Harperone, 2013, www.booktopia.com.au/super-immunity-joel-fuhrman/prod9780062080646.html.

Greger, Michael, and Gene Stone. How Not to Die: Discover the Foods Scientifically Proven to Prevent and Reverse Disease. London, Pan Books, 2018.

Greger, Michael. How Not to Diet: The Groundbreaking Science of Healthy, Permanent Weight Loss. New York, Flatiron Books, 2019.

Griffiths, Ray. Mitochondria in Health and Disease: Personalized Nutrition for Healthcare Practitioners. London, Singing Dragon, 2018.

Haas, Elson M, and Sondra Barrett. Ultimate Immunity: Supercharge Your Body’s Natural Healing Powers. Emmaus, Pennsylvania, Rodale, 2015.

Haas, Elson M. Staying Healthy with NEW Medicine: Integrating Natural, Eastern and Western Approaches for Optimal Health. San Rafael, California, Elson Haas, Md, 2016.

Healey, Francie. Eat to Beat Alzheimer’s: Delicious Recipes and New Research to Prevent and Slow Dementia. Santa Fe, New Mexico, Terra Nova Books, 2016.

Hunter, Fiona, and Caroline Bretherton. Super Clean Super Foods. London Dorling Kindersley Limited, 2017.

Insel, Paul M, et al. Nutrition. Burlington, Massachusetts, Jones & Bartlett Learning, 2017.

Lustig, Robert H. Fat Chance: Beating the Odds against Sugar, Processed Food, Obesity, and Disease. New York, New York, A Plume Book, 2014.

Marber, Ian. The Food Doctor Ultimate Diet. London, Dorling Kindersley, 2009.

Mazo, Ellen, et al. The Immune Advantage: The Powerful Natural Immune-Boosting Program to Help You Prevent Disease, Enhance Vitality, Live a Longer, Healthier Life. Emmaus, Pa, Rodale, 2002.

Mcdougall, John A, and Mary A Mcdougall. The Starch Solution: Eat the Foods You Love, Regain Your Health, and Lose the Weight for Good! New York, Rodale, 2013.

Mosconi, Lisa. Brain Food: The Surprising Science of Eating for Cognitive Power. London, Penguin Life, 2019.

Nardo, Don. Vegan Diets. Farmington Hills, Michigan, Lucent Books, An Imprint Of Gale Cengage Learning, 2014.

Norris, Jack, and Virginia Messina. Vegan for Life: Everything You Need to Know to Be Healthy and Fit on a Plant-Based Diet. Cambridge, Ma, Da Capo Press, 2011.

Pollan, Michael, and Maira Kalman. Food Rules: An Eater’s Manual. New York, N.Y., Penguin Books, 2013.

Pollan, Michael. In Defense of Food. Penguin, 2010.

Pulde, Alona, et al. The Forks over Knives Plan: How to Transition to the Life-Saving, Whole-Food, Plant-Based Diet. New York, Touchstone, An Imprint Of Simon & Schuster, Inc, 2017.

Quinn, Sue. Super Foods Every Day: Recipes Using Kale, Blueberries, Chia Seeds, Cacao, and Other Ingredients That Promote Whole-Body Health. Berkeley, Ten Speed Press, 2015.

Reader’s Digest Association. Family Guide to Natural Medicine: How to Stay Healthy the Natural Way. Pleasantville, N.Y., Reader’s Digest Association, 1993.

Reece, Gemma. Brain Food. Bath, Love Food, 2016.

Senior, Nicole, and Veronica Cuskelly. Eat to Beat Cholesterol. Chatswood Nsw New Holland Publishers (Australia) Pty Ltd, 2016.

Shanahan, Catherine, and Luke Shanahan. Deep Nutrition: Why Your Genes Need Traditional Food. New York, Flatiron Books, 2018.

Stepaniak, Joanne, and Virginia Messina. The Vegan Sourcebook. Los Angeles, Mcgraw Hill, 2000.

Stone, Gene, et al. Forks over Knives: The Plant-Based Way to Health. Camberwell, Vic., Penguin Group (Australia, 2012.

Super Foods Cookbook: 184 Super Easy Recipes to Boost Your Health. New York, NY ; Montreal, Reader’s Digest, The Reader’s Digest Association, Inc, 2014.

T, Michael, and Pizzorno Joseph Murray. The Encyclopedia of Natural Medicine Third Edition. Atria Books, 2012.

The Hacking of the American Mind: The Science behind the Corporate Takeover of Our Bodies and Brains. New York, New York, Avery, 2018.

Wilson, Bee. The Way We Eat Now: How the Food Revolution Has Transformed Our Lives, Our Bodies, and Our World. New York, Basic Books, 2019.

Yeager, Selene, and Pa. The Doctors Book of Food Remedies: The Latest Findings on the Power of Food to Treat and Prevent Health Problems-from Aging and Diabetes to Ulcers and Yeast Infections. Emmaus, Pa., Rodale, 2012.

Anxiety and phytonutrients

Wu, Aiguo, et al. “Curcumin Boosts DHA in the Brain: Implications for the Prevention of Anxiety Disorders.” Biochimica et Biophysica Acta (BBA) – Molecular Basis of Disease, vol. 1852, no. 5, 1 May 2015, pp. 951–961, www.sciencedirect.com/science/article/pii/S0925443914003779, 10.1016/j.bbadis.2014.12.005. Furthermore, in vivo treatment with curcumin and ALA reduced anxiety-like behavior in rodents. Taken together, these data suggest that curcumin enhances DHA synthesis, resulting in elevated brain DHA content.

Anxiety – Alternative treatments

Anxiety and anti-oxidants

Anxiety and omega-3

Su, Kuan-Pin, et al. “Association of Use of Omega-3 Polyunsaturated Fatty Acids with Changes in Severity of Anxiety Symptoms.” JAMA Network Open, vol. 1, no. 5, 14 Sept. 2018, p. e182327, jamanetwork.com/journals/jamanetworkopen/fullarticle/2702216?fbclid=IwAR1SjNfcZuYRkIsjFl8ok5CHLc8cQAt4WEcCQUBXYpnqf5XoxIrwNh2y5vI, 10.1001/jamanetworkopen.2018.2327. Omega-3 polyunsaturated fatty acid treatment for anxiety might be effective in clinical settings.

Grosso, Giuseppe, et al. “Omega-3 Fatty Acids and Depression: Scientific Evidence and Biological Mechanisms.” Oxidative Medicine and Cellular Longevity, vol. 2014, 2014, pp. 1–16, 10.1155/2014/313570.

Newman, Tim. “Could Omega-3 Supplements Help Reduce Anxiety?” Www.medicalnewstoday.com, 15 Oct. 2018, www.medicalnewstoday.com/articles/323331. A recently published meta-analysis concludes that omega-3 oil supplements might reduce symptoms of anxiety for some people.

PhD, David Mischoulon, MD. “Omega-3 Fatty Acids for Mood Disorders.” Harvard Health Blog, 3 Aug. 2018, www.health.harvard.edu/blog/omega-3-fatty-acids-for-mood-disorders-2018080314414. wo omega-3 fatty acids — eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) — are thought to have the most potential to benefit people with mood disorders.

Hollis, Fiona, et al. “Medium Chain Triglyceride Diet Reduces Anxiety-like Behaviors and Enhances Social Competitiveness in Rats.” Neuropharmacology, vol. 138, 1 Aug. 2018, pp. 245–256, pubmed.ncbi.nlm.nih.gov/29908242/, 10.1016/j.neuropharm.2018.06.017. Accessed 14 Jan. 2022. Altogether, our findings strongly suggest the effectiveness of MCT diet to exert anxiolytic effects. In the brain, our results point to the mPFC as a brain region in which MCT supplementation improves transport and control of energy substrates.

Lange, Klaus W. “Omega-3 Fatty Acids and Mental Health.” Global Health Journal, Mar. 2020, 10.1016/j.glohj.2020.01.004. Nutrition plays a key role in brain development, mental health, and psychiatric disorders. The role of omega-3 polyunsaturated fatty acids in physical health is well established, and their role in mental health is becoming increasingly evident.

Anxiety, stress and magnesium

Anxiety and Selenium

Anxiety, stress and zinc

Anxiety and iodine

Anxiety, stress and Vitamin D

Armstrong, D. J., et al. “Vitamin D Deficiency Is Associated with Anxiety and Depression in Fibromyalgia.” Clinical Rheumatology, vol. 26, no. 4, 19 July 2006, pp. 551–554, link.springer.com/article/10.1007%2Fs10067-006-0348-5, 10.1007/s10067-006-0348-5. Accessed 28 Nov. 2019. Vitamin D deficiency is common in fibromyalgia and occurs more frequently in patients with anxiety and depression. The nature and direction of the causal relationship remains unclear, but there are definite implications for long-term bone health.

Cheng, Ying‐Chih, et al. “The Effect of Vitamin D Supplement on Negative Emotions: A Systematic Review and Meta‐Analysis.” Depression and Anxiety, 4 May 2020, 10.1002/da.23025. Our results support the hypothesis that vitamin D supplementation can reduce negative emotions. Patients with major depressive disorder and individuals with vitamin D deficiency are most likely to benefit from supplementation. But to interpret the results with high heterogeneity should still be cautious.

Eid, Alaa, et al. “Vitamin D Supplementation Ameliorates Severity of Generalized Anxiety Disorder (GAD).” Metabolic Brain Disease, vol. 34, no. 6, 1 Dec. 2019, pp. 1781–1786, pubmed.ncbi.nlm.nih.gov/31478182/, 10.1007/s11011-019-00486-1. Accessed 10 Mar. 2021. Vitamin D supplementation was effective in ameliorating the severity of GAD symptoms by increasing serotonin concentrations and decreasing the levels of the inflammatory biomarker neopterin in GAD patients.

Fazelian, Siavash, et al. “Effect of Vitamin D Supplement on Mood Status and Inflammation in Vitamin D Deficient Type 2 Diabetic Women with Anxiety: A Randomized Clinical Trial.” International Journal of Preventive Medicine, vol. 10, 2019, p. 17, www.ncbi.nlm.nih.gov/pmc/articles/PMC6390422/, 10.4103/ijpvm.IJPVM_174_18. Vitamin D supplementation can improve mood status and anti-inflammatory biomarkers in female diabetics with anxiety and vitamin D deficiency.

Healthspan. “How Vitamin D Can Help with Stress and Anxiety in Sport.” Healthspan, www.healthspan.co.uk/advice/how-vitamin-d-can-help-with-stress-and-anxiety-in-sport. Not only will having enough vitamin D help you cope with stress, it may also help you deal with the causes of your stress. For example, do you worry about your performance levels? If so, it’s essential you keep your vitamin D topped up: it has been shown to increase athletic performance in vitamin D-deficient athletes.

Menon, Vikas, et al. “Vitamin D and Depression: A Critical Appraisal of the Evidence and Future Directions.” Indian Journal of Psychological Medicine, vol. 42, no. 1, 2020, p. 11, 10.4103/ijpsym.ijpsym_160_19. Accessed 13 Feb. 2020. Overall findings were that there is a relationship between vitamin D and depression, though the directionality of this association remains unclear. The association appears to be driven by the homeostatic, trophic, and immunomodulatory effects of vitamin D. Evidence from supplementation trials suggest a more robust therapeutic effect on subjects with major depression and concurrent vitamin D deficiency.

Bičíková, M., et al. “Vitamin D in Anxiety and Affective Disorders.” Physiological Research, vol. 64, no. Suppl 2, 2015, pp. S101-103, pubmed.ncbi.nlm.nih.gov/26680471/, 10.33549/physiolres.933082. Accessed 18 Oct. 2020. Significantly lower levels of calcidiol were found in men and women with depression as well as in age matched patients with anxiety disorders.

Vitamin D – general

Adda Bjarnadottir, MS. “How Much Vitamin D Should You Take for Optimal Health?” Healthline, Healthline Media, 4 June 2017, www.healthline.com/nutrition/how-much-vitamin-d-to-take.

Al-Dujaili, Emad A. S., et al. “Effect of Vitamin D Supplementation on Cardiovascular Disease Risk Factors and Exercise Performance in Healthy Participants: A Randomized Placebo-Controlled Preliminary Study.” Therapeutic Advances in Endocrinology and Metabolism, vol. 7, no. 4, 1 Aug. 2016, pp. 153–165, www.ncbi.nlm.nih.gov/pmc/articles/PMC4973406/, 10.1177/2042018816653357. The current study indicates that vitamin D has the potential to reduce cortisol levels and the cortisol:cortisone ratio. Suboptimal levels of vitamin D have been associated with impaired exercise performance, as it reduces muscle action and skeletal mineralisation [Wyon et al.].

Armstrong, D. J., et al. “Vitamin D Deficiency Is Associated with Anxiety and Depression in Fibromyalgia.” Clinical Rheumatology, vol. 26, no. 4, 19 July 2006, pp. 551–554, link.springer.com/article/10.1007%2Fs10067-006-0348-5, 10.1007/s10067-006-0348-5. Accessed 28 Nov. 2019. Vitamin D deficiency is common in fibromyalgia and occurs more frequently in patients with anxiety and depression. The nature and direction of the causal relationship remains unclear, but there are definite implications for long-term bone health.

Bičíková, M., et al. “Vitamin D in Anxiety and Affective Disorders.” Physiological Research, vol. 64, no. Suppl 2, 2015, pp. S101-103, pubmed.ncbi.nlm.nih.gov/26680471/, 10.33549/physiolres.933082. Accessed 18 Oct. 2020. Significantly lower levels of calcidiol were found in men and women with depression as well as in age matched patients with anxiety disorders.

—. “Vitamin D in Anxiety and Affective Disorders.” Physiological Research, vol. 64, no. Suppl 2, 2015, pp. S101-103, pubmed.ncbi.nlm.nih.gov/26680471/, 10.33549/physiolres.933082. “In conclusion, we could confirm that affective disorders are associated with significantly lower levels of calcidiol, the precursor of the active hormone calcitriol, both for men and women. In contrast to the findings of Black et al. (2014), the association of vitamin D deficiency was recorded not only for depression but also for anxiety disorders with no significant differences between both studied groups.

“Calcium/Vitamin D Requirements, Recommended Foods & Supplements.” National Osteoporosis Foundation, 2015, www.nof.org/patients/treatment/calciumvitamin-d/.

Cheng, Ying‐Chih, et al. “The Effect of Vitamin D Supplement on Negative Emotions: A Systematic Review and Meta‐Analysis.” Depression and Anxiety, 4 May 2020, 10.1002/da.23025. Our results support the hypothesis that vitamin D supplementation can reduce negative emotions. Patients with major depressive disorder and individuals with vitamin D deficiency are most likely to benefit from supplementation. But to interpret the results with high heterogeneity should still be cautious.

Eid, Alaa, et al. “Vitamin D Supplementation Ameliorates Severity of Generalized Anxiety Disorder (GAD).” Metabolic Brain Disease, vol. 34, no. 6, 1 Dec. 2019, pp. 1781–1786, pubmed.ncbi.nlm.nih.gov/31478182/, 10.1007/s11011-019-00486-1. Accessed 10 Mar. 2021. Vitamin D supplementation was effective in ameliorating the severity of GAD symptoms by increasing serotonin concentrations and decreasing the levels of the inflammatory biomarker neopterin in GAD patients.

Fazelian, Siavash, et al. “Effect of Vitamin D Supplement on Mood Status and Inflammation in Vitamin D Deficient Type 2 Diabetic Women with Anxiety: A Randomized Clinical Trial.” International Journal of Preventive Medicine, vol. 10, 2019, p. 17, www.ncbi.nlm.nih.gov/pmc/articles/PMC6390422/, 10.4103/ijpvm.IJPVM_174_18. Vitamin D supplementation can improve mood status and anti-inflammatory biomarkers in female diabetics with anxiety and vitamin D deficiency.

Healthspan. “How Vitamin D Can Help with Stress and Anxiety in Sport.” Healthspan, www.healthspan.co.uk/advice/how-vitamin-d-can-help-with-stress-and-anxiety-in-sport. Not only will having enough vitamin D help you cope with stress, it may also help you deal with the causes of your stress. For example, do you worry about your performance levels? If so, it’s essential you keep your vitamin D topped up: it has been shown to increase athletic performance in vitamin D-deficient athletes.

“How to Spot a Vitamin D Deficiency.” Www.unitypoint.org, www.unitypoint.org/livewell/article.aspx?id=ca7f4766-8ba8-43a2-bbe7-0ef9efab5c6d. Accessed 1 July 2020.

Menon, Vikas, et al. “Vitamin D and Depression: A Critical Appraisal of the Evidence and Future Directions.” Indian Journal of Psychological Medicine, vol. 42, no. 1, 2020, p. 11, 10.4103/ijpsym.ijpsym_160_19. Accessed 13 Feb. 2020. Overall findings were that there is a relationship between vitamin D and depression, though the directionality of this association remains unclear. The association appears to be driven by the homeostatic, trophic, and immunomodulatory effects of vitamin D. Evidence from supplementation trials suggest a more robust therapeutic effect on subjects with major depression and concurrent vitamin D deficiency.

NHS Choices. “Vitamin D – Vitamins and Minerals.” NHS, 2019, www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/.

“Office of Dietary Supplements – Vitamin D.” Nih.gov, 2017, ods.od.nih.gov/factsheets/VitaminD-Consumer/.

Penckofer, Sue, et al. “Vitamin D and Depression: Where Is All the Sunshine?” Issues in Mental Health Nursing, vol. 31, no. 6, May 2010, pp. 385–393, www.ncbi.nlm.nih.gov/pmc/articles/PMC2908269/, 10.3109/01612840903437657. If exercising outdoors in the sunshine, eating foods rich in vitamin D, and/or taking dietary supplements to improve vitamin D deficiency could improve one’s mental well being, it would be a simple and cost-effective solution for many who are at risk for depression and possibly other mental disorders.

“Should You Be Taking a Vitamin D Supplement? | Nutrition.” Www.veganfoodandliving.com, www.veganfoodandliving.com/vegan-diet/vegan-nutrition/vitamin-d-should-you-be-taking-a-supplement/. Accessed 1 July 2020.

“Supplements for Anxiety: Best Types and Evidence.” Www.medicalnewstoday.com, www.medicalnewstoday.com/articles/325823#vitamin-d. Research has established a link between vitamin D levels and depression, claiming that taking vitamin D supplements may help treat the condition.

“Vitamin D.” The Vegan Society, www.vegansociety.com/resources/nutrition-and-health/nutrients/vitamin-d.

“Vitamin D Deficiency.” Medlineplus.gov, National Library of Medicine, 2019, medlineplus.gov/vitaminddeficiency.html.

“Vitamin D Deficiency and Treatment.” MedicineNet, MedicineNet, 12 Aug. 2016, www.medicinenet.com/nutritional_health_vitamin_d_pictures_slideshow/article.htm.

“Vitamin D Deficiency: Causes, Symptoms, and Treatment.” Www.medicalnewstoday.com, www.medicalnewstoday.com/articles/318060.

Zhu, Cuizhen, et al. “Vitamin D Supplementation Improves Anxiety but Not Depression Symptoms in Patients with Vitamin D Deficiency.” Brain and Behavior, vol. 10, no. 11, 18 Sept. 2020, 10.1002/brb3.1760. Accessed 10 Mar. 2021. Vitamin D supplementation could improve the anxiety symptoms but not depressive symptoms in depressive patients with low VD level after the 6‐month intervention.

Anxiety, stress and vitamin C

Bauer, Brent A. “Can Vitamin c Boost Your Mood?” Mayo Clinic, mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/benefits-vitamin-c/faq-20058271. Accessed Mar. 2021. The link between vitamin C and mood might seem surprising, but people who have vitamin C deficiency often feel fatigued or depressed. Some studies have shown that people who have lower than normal vitamin C levels found that their mood improved after they received vitamin C.

“Calm Cognition: How Vitamin c Helps Anxiety, Focus and Mood – Natural Calm Canada.” Naturalcalm.ca, 2018, naturalcalm.ca/vitamin-c-brain-health-mood-anxiety-focus/. Accessed Mar. 2021. Our bodies require antioxidants such as vitamin C to keep free radicals in check. When there are more free radicals than antioxidants, oxidative stress occurs. Oxidative stress can cause neuropsychological disorders like depression and anxiety.

“Can Vitamin c Boost Your Mood?” Mayo Clinic, 2017, www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/benefits-vitamin-c/faq-20058271.

“Got Stress? You Need Vitamin C.” Dr. James L. Wilson’s AdrenalFatigue.org, Jan. 2018, adrenalfatigue.org/got-stress-you-need-vitamin-c/. Accessed Mar. 2021. As you surely know by now, vitamin C is essential to health. Although it is commonly used to prevent scurvy and for immune support, there are many other benefits to taking vitamin C. For example, increased concentrations of vitamin C in the blood have been shown to have a positive effect on the cardiovascular system, skin, nervous system, teeth, bone density, immune function, and glands such as the thymus, adrenals and thyroid. Scientific studies have linked vitamin C with immune system function and the health of the eyes, cardiovascular system, liver, and joints.

Koizumi, Miwako, et al. “Vitamin c Impacts Anxiety-like Behavior and Stress-Induced Anorexia Relative to Social Environment in SMP30/GNL Knockout Mice.” Nutrition Research, vol. 36, Dec. 2016, pp. 1379–1391, www.sciencedirect.com/science/article/pii/S0271531716306728?via%3Dihub, 10.1016/j.nutres.2016.11.006. Accessed May 2020.

Lima, Jesus, et al. “Effects of Oral Vitamin c Supplementation on Anxiety in Students: A Double-Blind, Randomized, Placebo-Controlled Trial.” Pakistan Journal of Biological Sciences : PJBS, vol. 18, 2015, pp. 11–8, www.ncbi.nlm.nih.gov/pubmed/26353411, 10.3923/pjbs.2015.11.18. Vitamin C (ascorbic acid) is a well-known antioxidant that is involved in anxiety, stress, depression, fatigue and mood state in humans. Studies have suggested that oxidative stress may trigger neuropsychological disorders. Antioxidants may play an important therapeutic role in combating the damage caused by oxidative stress in individuals that suffer from anxiety.

M, Peters E, et al. “Vitamin c Supplementation Attenuates the Increases in Circulating Cortisol, Adrenaline and Anti-Inflammatory Polypeptides Following Ultramarathon Running.” International Journal of Sports Medicine, vol. 22, Oct. 2001, pp. 537–543, pubmed.ncbi.nlm.nih.gov/11590482/, 10.1055/s-2001-17610. Accessed Mar. 2021.

Mazloom, Zohreh, et al. “Efficacy of Supplementary Vitamins c and E on Anxiety, Depression and Stress in Type 2 Diabetic Patients: A Randomized, Single-Blind, Placebo-Controlled Trial.” Pakistan Journal of Biological Sciences: PJBS, vol. 16, Nov. 2013, pp. 1597–1600, pubmed.ncbi.nlm.nih.gov/24511708/, 10.3923/pjbs.2013.1597.1600. Accessed Mar. 2021. Thus, it seems that diabetes could accelerate the trend of psychiatric diseases. In this randomized single-blind study, evaluation of the effects of two antioxidants (vitamin C and vitamin E) was done on Stress, depression and anxiety levels in 45 diabetic patients for six weeks. The patients were randomly divided in three groups of vitamin E (400 IU day(-1)), vitamin C (1000 mg day(-1)) and placebo. DASS-21 (Depression Anxiety Stress Scales 21-item) questionnaire items were read to each patient and completed by the main investigator of this study before and after six weeks of supplementation. The scores of depression, anxiety and stress were evaluated separately based on the DASS questionnaire. The results showed a significant decrease in anxiety level (p = 0.005) in vitamin C group compared to other groups but there were no significant differences between groups in terms of changes in stress and depression scores. In conclusion, this study suggests that short-term supplementation of vitamin C is safe and beneficial for reducing anxiety levels in diabetic patients through alleviating oxidative damage.

“The Role of Vitamin c in Stress-Related Disorders.” The Journal of Nutritional Biochemistry, vol. 85, Nov. 2020, p. 108459, www.sciencedirect.com/science/article/pii/S0955286320304915, 10.1016/j.jnutbio.2020.108459. Accessed Mar. 2021. Stress-related disorders, such as depression and anxiety, present marked deficits in behavioral and cognitive functions related to reward. These are highly prevalent disabling conditions with high social and economic costs. Furthermore, a significant percentage of affected individuals cannot benefit from clinical intervention, opening space for new treatments.

“Vitamin C: Stress Buster | Psychology Today United Kingdom.” Www.psychologytoday.com, www.psychologytoday.com/gb/articles/200304/vitamin-c-stress-buster. Accessed Mar. 2021. People who have high levels of vitamin C do not show the expected mental and physical signs of stress when subjected to acute psychological challenges. What’s more, they bounce back from stressful situations faster than people with low levels of vitamin C in their blood.

“Why You Need Vitamin c in Your Body Every Day.” ICRYO – Recovery & Wellness, 11 Apr. 2020, icryo.com/why-you-need-vitamin-c-every-day/. Accessed 15 Jan. 2022.

Zdravic, Ana. “Vitamin c Decreases Depression and Affects Cognition.” Maze Engineers, July 2018, conductscience.com/maze/vitamin-c-depression-and-cognition/. Accessed Mar. 2021. The relationship between vitamin C and depression has only recently been established scientifically, but it has been a strong one. Studying vitamin C deficiencies is quickly becoming more common in the scientific realm due to the fact that contemporary diets (high in convenience, fast foods) are reducing the amount of time that people spend preparing and eating fresh foods, thus causing vitamin deficiencies which affect cognition and behavior. In fact, vitamin C deficiencies have been established in the community at large, the hospitalized elderly, and college students. Such findings are a cause for concern due to the negative impacts that emerge as a result of vitamin C deficiency.

“Scientists Say Vitamin c May Alleviate the Body’s Response to Stress.” ScienceDaily, www.sciencedaily.com/releases/1999/08/990823072615.htm. Accessed Mar. 2021. The study showed that vitamin C reduced the levels of stress hormones in the blood-and also reduced other typical indicators of physical and emotional stress, such as loss in body weight, enlargement of the adrenal glands, and reduction in the size of the thymus gland and the spleen, according to Campbell.

Padayatty, Sebastian J, et al. “Human Adrenal Glands Secrete Vitamin c in Response to Adrenocorticotrophic Hormone.” The American Journal of Clinical Nutrition, vol. 86, July 2007, pp. 145–149, academic.oup.com/ajcn/article/86/1/145/4754391, 10.1093/ajcn/86.1.145. Accessed Aug. 2019. Adrenocorticotrophic hormone stimulation increases adrenal vein but not peripheral vein vitamin C concentrations. These data are the first in humans showing that hormone-regulated vitamin secretion occurs and that adrenal vitamin C paracrine secretion is part of the stress response. Tight control of peripheral vitamin C concentration is permissive of higher local concentrations that may have paracrine functions.

Patak, P, et al. “Vitamin c Is an Important Cofactor for Both Adrenal Cortex and Adrenal Medulla.” Endocrine Research, vol. 30, Jan. 2004, pp. 871–875, 10.1081/erc-200044126. The data derived from these animal models and various cell culture studies confirm a crucial role for vitamin C for both the adrenal cortex as well as the adrenal medulla further underlining the interdependence of the two endocrine systems united in one gland.

Plevin, David, and Cherrie Galletly. “The Neuropsychiatric Effects of Vitamin c Deficiency: A Systematic Review.” BMC Psychiatry, vol. 20, June 2020, 10.1186/s12888-020-02730-w. Accessed June 2020. Vitamin C deficiency, including scurvy, has been linked to depression and cognitive impairment.

Pullar, Juliet M, et al. “High Vitamin c Status Is Associated with Elevated Mood in Male Tertiary Students.” Antioxidants, vol. 7, July 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6071228/, 10.3390/antiox7070091. Examination of the individual POMS subscales also showed inverse associations of vitamin C status with depression, confusion, and anger. These findings suggest that high vitamin C status may be associated with improved overall mood in young adult males.

Han, Qian-Qian, et al. “Preventive and Therapeutic Potential of Vitamin c in Mental Disorders.” Current Medical Science, vol. 38, Feb. 2018, pp. 1–10, pubmed.ncbi.nlm.nih.gov/30074145/, 10.1007/s11596-018-1840-2. In the past few decades, scientists have revealed that the deficiency of vitamin C may lead to motor deficit, cognitive impairment and aberrant behaviors, whereas supplement of vitamin C has a potential preventive and therapeutic effect on mental illness, such as major depressive disorder (MDD), schizophrenia, anxiety and Alzheimer’s disease (AD).

McCabe;Karolina, Delia. “The Impact of Essential Fatty Acid, B Vitamins, Vitamin C, Magnesium and Zinc Supplementation on Stress Levels in Women.” Jbi Database of Systematic Reviews and Implementation Reports, vol. 15, 2013, pp. 402–453, insights.ovid.com/pubmed?pmid=28178022, 10.11124/JBISRIR-2016-002965. Accessed Apr. 2019. The current review suggests that EFAs may be effective in reducing prenatal stress and salivary cortisol and may reduce anxiety during premenstrual syndrome and during menopause in the absence of depression. Magnesium and vitamin B6 may be effective in combination in reducing premenstrual stress, and vitamin B6 alone may reduce anxiety effectively in older women. High-dose sustained-release vitamin C may reduce anxiety and mitigate increased blood pressure in response to stress.

Moritz, Bettina, et al. “Effects of Ascorbic Acid on Anxiety State and Affect in a Non-Clinical Sample.” Acta Neurobiologiae Experimentalis, vol. 77, 2017, pp. 362–372, pubmed.ncbi.nlm.nih.gov/29369301/. However, the ingestion of ascorbic acid by the 25% more anxious healthy subjects (women; 14 control and 23 ascorbic acid), as defined by the STAI trait‑anxiety scale, produced a significant reduction from baseline anxiety scores in the STAI state‑anxiety scale and VAMS anxiety subscale.

Anxiety, stress and vitamin E

“High Doses of Vitamin E Supplements Do More Harm than Good.” ScienceDaily, American Heart Association, 18 Nov. 2004, www.sciencedaily.com/releases/2004/11/041116233312.htm.

“Https://En.wikipedia.org/Wiki/Samphire.” Wikpedia, From Wikipedia, the free encyclopedia. https://en.wikipedia.org/wiki/Talk%3ASamphire.

“Https://Www.cancer.gov/Publications/Dictionaries/Cancer-Terms/Def/Alpha-Tocopherol.” Www.cancer.gov, 2 Feb. 2011, www.cancer.gov/publications/dictionaries/cancer-terms/def/alpha-tocopherol. alpha-tocopherol is fat-soluble (can dissolve in fats and oils) and is found in seeds, nuts, leafy green vegetables, and vegetable oils. Alpha-tocopherol boosts the immune system and helps keep blood clots from forming. It also helps prevent cell damage caused by free radicals (highly reactive chemicals).

“Office of Dietary Supplements – Vitamin E.” Nih.gov, 2017, ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/. Nuts, seeds, and vegetable oils are among the best sources of alpha-tocopherol, and significant amounts are available in green leafy vegetables and fortified cereals.

“Vitamin | HSIS.” Www.hsis.org, www.hsis.org/supplements/vitamin/.

Atli Arnarson, PhD. “20 Foods That Are High in Vitamin E.” Healthline, Healthline Media, 24 May 2017, www.healthline.com/nutrition/foods-high-in-vitamin-e#section1.

Cudmore, Dale. “The 30 Best Vegan Vitamin E Food [Data].” VegFAQs, 6 July 2018, vegfaqs.com/vegan-vitamin-e-food-sources/. Accessed 3 July 2020.

Gautam, Medhavi, et al. “Role of Antioxidants in Generalised Anxiety Disorder and Depression.” Indian Journal of Psychiatry, vol. 54, no. 3, 2012, p. 244, 10.4103/0019-5545.102424. The findings suggest that antioxidant supplement therapy as an adjuvant therapy is useful in patients with stress-induced psychiatric disorders and the results have been discussed.

Justine. “Vitamin E.” Viva! Health, 15 Aug. 2018, www.vivahealth.org.uk/a-z/vitamin-e. Accessed 3 July 2020.

MD, Uma Naidoo. “Nutritional Strategies to Ease Anxiety.” Harvard Health Blog, 13 Apr. 2016, www.health.harvard.edu/blog/nutritional-strategies-to-ease-anxiety-201604139441#:~:text=Anxiety%20is%20thought%20to%20be. Accessed 10 Mar. 2021. Anxiety is thought to be correlated with a lowered total antioxidant state. It stands to reason, therefore, that enhancing your diet with foods rich in antioxidants may help ease the symptoms of anxiety disorders. A 2010 study reviewed the antioxidant content of 3,100 foods, spices, herbs, beverages, and supplements.

Publishing, Harvard Health. “Easy Does It with Vitamin E.” Harvard Health, www.health.harvard.edu/newsletter_article/Easy_does_it_with_vitamin_E.

Terada, Yuki, et al. “Increased Anxiety-like Behaviour Is an Early Symptom of Vitamin E Deficiency That Is Suppressed by Adrenalectomy in Rats.” British Journal of Nutrition, 1 June 2020, pp. 1–10, www.cambridge.org/core/journals/british-journal-of-nutrition/article/increased-anxietylike-behavior-is-an-early-symptom-of-vitamin-e-deficiency-that-is-suppressed-by-adrenalectomy-in-rats/30FE83F0CC38D4060277E55022D8B660, 10.1017/S0007114520001889. Accessed 10 Mar. 2021. Vitamin E deficiency increased anxiety-like behaviour in open arm activity, head dipping and stretch out (Fig. 2). Vitamin E refeeding significantly decreased anxiety-like behaviour in stretch out and tended to decrease them in open arm activity and head dipping (Fig. 2). Vitamin E deficiency or refeeding did not affect locomotion (Fig. 2).

Whitbread, Daisy. “Top 10 Foods Highest in Vitamin E.” Myfooddata, My Food Data, 31 Aug. 2008, www.myfooddata.com/articles/vitamin-e-foods.php.

Xu, Ying, et al. “Novel Therapeutic Targets in Depression and Anxiety: Antioxidants as a Candidate Treatment.” Current Neuropharmacology, vol. 12, no. 2, 1 Mar. 2014, pp. 108–119, www.ncbi.nlm.nih.gov/pmc/articles/PMC3964743/, 10.2174/1570159X11666131120231448. There is growing evidence that the imbalance between oxidative stress and the antioxidant defense system may be associated with the development neuropsychiatric disorders, such as depression and anxiety.

Zdravic, Ana. “Vitamin E Affects Anxiety and Other Behaviors.” Maze Engineers, 31 Mar. 2018, conductscience.com/maze/vitamin-e-affects-anxiety-and-other-behaviors/#:~:text=Using%20an%20elevated%20plus%2Dmaze. Accessed 10 Mar. 2021. Using an elevated plus-maze test and tissue samples to determine the animals’ levels of the alpha-tocopherol concentrations, researchers showed that anxiety behaviors and Vitamin E have an inverse relationship. In other words, as Vitamin E decreases, anxiety-like behaviors increase.[4] To summarize the experiment, the animals that were on the vitamin E-deficient diet had different behavioral outcomes and tissue properties when compared to those of the control group. The plasma, liver, and brain samples of the young rats and older rats in the vitamin E-deficient group had significantly lower alpha-tocopherol concentration levels.

Anxiety and the microbiome/gut

Works Cited

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Wan Y, Wang F, Yuan J, et al. Effects of dietary fat on gut microbiota and faecal metabolites, and their relationship with cardiometabolic risk factors: a 6-month randomised controlled-feeding trial. Gut. 2019; 0:1-13. doi: 10.1136/gutjnl-2018-317609.

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Yan, Xiaohui, et al. “Apigenin in Cancer Therapy: Anti-Cancer Effects and Mechanisms of Action.” Cell & Bioscience, vol. 7, no. 1, 5 Oct. 2017, 10.1186/s13578-017-0179-x. Found in parsley.

Anxiety, stress and the B vitamins

@lisaperryRDN. “Connecting the Symptom Dots: Discovering My Thiamine Deficiency.” Hormones Matter, 23 Mar. 2017, www.hormonesmatter.com/connecting-symptom-dots-discovering-thiamine-deficiency/. Accessed 15 Jan. 2022.

“4 Nutrients Depleted during Times of High Stress.” PI Therapy, Mar. 2019, pitherapy.com.au/4-nutrients-depleted-during-times-of-high-stress/.

“10 Vegan Vitamin B12 Supplements.” One Green Planet, Jan. 2020, www.onegreenplanet.org/natural-health/vegan-vitamin-b12-supplements/. Accessed July 2020.

“11 Signs and Symptoms of Thiamine (Vitamin B1) Deficiency.” Healthline, 2018, www.healthline.com/nutrition/thiamine-deficiency-symptoms.

“11 Signs and Symptoms of Thiamine (Vitamin B1) Deficiency.” Healthline, 2018, www.healthline.com/nutrition/thiamine-deficiency-symptoms.

Ahgilan, Aarthi, et al. “Antimicrobial Properties of Vitamin B2.” International Journal of Food Properties, vol. 19, no. 5, Sept. 2015, pp. 1173–1181, 10.1080/10942912.2015.1076459.

“Biotin – Vitamin B7.” The Nutrition Source, July 2019, www.hsph.harvard.edu/nutritionsource/biotin-vitamin-b7/.

“Biotin: Uses, Side Effects, Interactions, Dosage, and Warning.” Webmd.com, 2010, www.webmd.com/vitamins/ai/ingredientmono-313/biotin.

Bistas, Karlyle G, and Prasanna Tadi. “Biotin.” PubMed, StatPearls Publishing, 2020, www.ncbi.nlm.nih.gov/books/NBK554493/.

Bjelland, Ingvar, et al. “Choline in Anxiety and Depression: The Hordaland Health Study.” The American Journal of Clinical Nutrition, vol. 90, Aug. 2009, pp. 1056–1060, academic.oup.com/ajcn/article/90/4/1056/4596992, 10.3945/ajcn.2009.27493. Accessed Nov. 2020. In this large population-based study, choline concentrations were negatively associated with anxiety symptoms but not with depression symptoms.

Bowman, Joe. “What Does Vitamin B-1 Do?” Healthline, Healthline Media, 22 Oct. 2014, www.healthline.com/health/vitamin-watch-b1-thiamine.

Bradford, Alina. “What Is Biotin (Vitamin B7)?” Livescience.com, www.livescience.com/51696-biotin-vitamin-b7.html.

Carmel, R. “Current Concepts in Cobalamin Deficiency.” Annual Review of Medicine, vol. 51, 2000, pp. 357–375, www.ncbi.nlm.nih.gov/pubmed/10774470, 10.1146/annurev.med.51.1.357. Accessed July 2020.

Ch, et al. “Thiamine and Riboflavin for Chronic Fatigue.” Hormones Matter, 31 Oct. 2018, www.hormonesmatter.com/thiamine-riboflavin-chronic-fatigue/.

Contributors, WebMD Editorial. “Health Benefits of Vitamin B1.” WebMD, 23 June 2021, www.webmd.com/vitamins-and-supplements/health-benefits-of-vitamin-b-1.

—. “Health Benefits of Vitamin B1.” WebMD, 23 June 2021, www.webmd.com/vitamins-and-supplements/health-benefits-of-vitamin-b-1.

Cornish, Stacey, and Lewis Mehl-Madrona. “The Role of Vitamins and Minerals in Psychiatry.” Integrative Medicine Insights, vol. 3, Sept. 2008, pp. 33–42, www.ncbi.nlm.nih.gov/pmc/articles/PMC3046018/. Thirty percent of patients hospitalized for depression were deficient in B12,75 and people who are deficient in B12 were 2.05 times more likely to be severely depressed than non-deficient subjects (28).76 One third of depressed patients had low folic acid levels, with treatment improving their depression.77 Low serum folate and B12 levels predicted refractory responses to antidepressant medication.78,79,80,81 The DRI for vitamin B-12 is 2.4 μg/d for adults. Cobalamin is the precursor to methylcobalamin and adenosylcobalamin, the bioactive cofactor forms of cobalamin. The DRI for folic acid is 400 μg/d.

Cudmore, Dale. “Should You Take Vitamin B12 Supplements with Food?” VegFAQs, Sept. 2019, vegfaqs.com/vitamin-b12-with-or-without-food/. Accessed July 2020.

Douaud, Gwenaëlle, et al. “Preventing Alzheimer’s Disease-Related Gray Matter Atrophy by B-Vitamin Treatment.” Proceedings of the National Academy of Sciences, vol. 110, May 2013, pp. 9523–9528, www.pnas.org/content/110/23/9523.short, 10.1073/pnas.1301816110. Accessed May 2019.

Drew. “Vegan Guide to Vitamin B6.” Your Vegan Journey, yourveganjourney.com/vegan-guide-to-vitamin-b6/. Accessed July 2020.

Durand, C, et al. “[Psychiatric Manifestations of Vitamin B12 Deficiency: A Case Report].” L’Encephale, vol. 29, Nov. 2003, pp. 560–565, pubmed.ncbi.nlm.nih.gov/15029091/. “Conclusion – We recommend consideration of B12 deficiency and serum B12 determinations in all the patients with organic mental disorders, atypical psychiatric symptoms and fluctuation of symptomatology.”

“Energy Production and B Vitamins.” Otsuka Pharmaceutical Co., Ltd., www.otsuka.co.jp/en/nutraceutical/about/nutrition/sports-nutrition/essential-nutrients/vitaminbcomplex.html.

“Getting Clarity about Calcium in Milk.” Forks over Knives, May 2015, www.forksoverknives.com/wellness/milk-myth-why-you-dont-need-dairy-for-calcium/. Accessed Aug. 2020.

Hall-Flavin, Daniel K. “Vitamin B-12 and Depression: Are They Related?” Mayo Clinic, 2018, www.mayoclinic.org/diseases-conditions/depression/expert-answers/vitamin-b12-and-depression/faq-20058077. Vitamin B-12 and other B vitamins play a role in producing brain chemicals that affect mood and other brain functions. Low levels of B-12 and other B vitamins such as vitamin B-6 and folate may be linked to depression.

“Intestinal Bacteria as a Vitamin B12 Source.” VeganHealth.org, veganhealth.org/intestinal-bacteria-as-b12-source/. Accessed July 2020.

Jayaram, Naveen, et al. “Vitamin B12Levels and Psychiatric Symptomatology: A Case Series.” The Journal of Neuropsychiatry and Clinical Neurosciences, vol. 25, Jan. 2013, pp. 150–152, 10.1176/appi.neuropsych.12060144. Accessed Mar. 2021. “In summary, this report emphasizes the importance of investigation for vitamin B12 deficiency in psychiatrically ill patients, especially those in high-risk groups. The downstream changes due to impaired DNA synthesis leading to the development of psychopathology are, as yet, unknown. Future studies are needed to further evaluate the role of vitamin B12 in the pathogenesis of psychiatric disorders.”

Jennings, Kerri-Ann. “9 Science-Based Benefits of Niacin (Vitamin B3).” Healthline, Healthline Media, Nov. 2018, www.healthline.com/nutrition/niacin-benefits.

Jones, Kristie. “Nutritional Treatments to Combat Anxiety Disorders.” Hospital News, Canada’s Health care news, Oct. 2005, hospitalnews.com/nutritional-treatments-to-combat-anxiety-disorders/. Adequate treatments should be provided to mitigate the suffering of these patients. One of the most effective ways to accomplish this is through the use of the amide of niacin (nicotinic acid) known as niacinamide (nicotinamide). This B-vitamin has remarkable therapeutic benefits for those suffering from anxiety.

—. “Nutritional Treatments to Combat Anxiety Disorders.” Hospital News, Oct. 2005, hospitalnews.com/nutritional-treatments-to-combat-anxiety-disorders/. Accessed Mar. 2021. It is well known that regular use of vitamin B12 helps those patients having had a documented deficiency. However, there are many other patients who seem to benefit psychologically from regular vitamin B12 injections despite the absence of diseases and diagnostic evidence of vitamin B12 deficiency.

Kennedy, David. “B Vitamins and the Brain: Mechanisms, Dose and Efficacy—a Review.” Nutrients, vol. 8, no. 2, 27 Jan. 2016, p. 68, www.ncbi.nlm.nih.gov/pmc/articles/PMC4772032/, 10.3390/nu8020068. The B vitamins represent a group of eight essential dietary micronutrients that work closely in concert at a cellular level and which are absolutely essential for every aspect of brain function.

—. “B Vitamins and the Brain: Mechanisms, Dose and Efficacy—a Review.” Nutrients, vol. 8, no. 2, 27 Jan. 2016, p. 68, www.ncbi.nlm.nih.gov/pmc/articles/PMC4772032/, 10.3390/nu8020068. As water soluble nutrients, they are generally safe at levels of consumption well in excess of the recommended minimum consumption levels (possibly with the exception of folic acid, see Section 5). Indeed, bioavailability and functional data suggest that consumption of most B vitamins at levels well above dietary recommendations would be warranted.

Kirchheimer, Sid. “Vegetarian Diet and B12 Deficiency.” WebMD, www.webmd.com/food-recipes/news/20030618/vegetarian-diet-b12-deficiency. Accessed July 2020.

Lake, James. “Inositol and Choline in Mental Health Care | Psychology Today United Kingdom.” Www.psychologytoday.com, Sept. 2017, www.psychologytoday.com/gb/blog/integrative-mental-health-care/201709/inositol-and-choline-in-mental-health-care. Accessed Jan. 2022. In a four-week, double-blind, crossover study (21 subjects), inositol at a dose of 12 gm per day and imipramine (a tricyclic antidepressant) were equally effective in reducing the frequency and severity of panic attacks in individuals diagnosed with panic disorder with and without agoraphobia.

LERNER, V, et al. “Vitamin B12 and Folate Serum Levels in Newly Admitted Psychiatric Patients.” Clinical Nutrition, vol. 25, Feb. 2006, pp. 60–67, 10.1016/j.clnu.2005.08.014. Accessed Mar. 2019. The results of our study suggest that folate levels be assessed in patients admitted to psychiatric wards, especially in those with depression.

Mahabadi, Navid, et al. “Riboflavin Deficiency.” StatPearls, 21 July 2021, www.statpearls.com/ArticleLibrary/viewarticle/28577.

Michaeli, Dov, et al. “This Is Why Vitamin B12 Is so Important.” The Doctor Weighs In, Feb. 2020, thedoctorweighsin.com/vitamin-b12-importance/. Accessed July 2020.

Navid Mahabadi, et al. “Riboflavin Deficiency.” Nih.gov, StatPearls Publishing, 3 July 2019, www.ncbi.nlm.nih.gov/books/NBK470460/.

Niacin. “Niacin.” Linus Pauling Institute, 22 Apr. 2014, lpi.oregonstate.edu/mic/vitamins/niacin.

O’Leary, Fiona, and Samir Samman. “Vitamin B12 in Health and Disease.” Nutrients, vol. 2, Mar. 2010, pp. 299–316, www.ncbi.nlm.nih.gov/pmc/articles/PMC3257642/, 10.3390/nu2030299. The symptoms of sub-clinical deficiency are subtle and often not recognized. The long-term consequences of sub-clinical deficiency are not fully known but may include adverse effects on pregnancy outcomes, vascular, cognitive, bone and eye health.

“Office of Dietary Supplements – Biotin.” Nih.gov, 2017, ods.od.nih.gov/factsheets/Biotin-HealthProfessional/.

Pawlak, Roman, et al. “How Prevalent Is Vitamin B(12) Deficiency among Vegetarians?” Nutrition Reviews, vol. 71, 2013, pp. 110–7, www.ncbi.nlm.nih.gov/pubmed/23356638, 10.1111/nure.12001. Accessed June 2019.

Pordes, Piriya Mahendra. “Vitamin B7 (Biotin): Deficiency, Benefits, Sources, Supplements.” Netdoctor, Apr. 2020, www.netdoctor.co.uk/healthy-eating/a10927/vitamin-b7-biotin/.

Prousky, Jonathan. “Niacinamide’s Potent Role in Alleviating Anxiety with Its Benzodiazepine-like Properties: A Case Report.” Https://Www.researchgate.net/, Journal of Orthomolecular Medicine, June 2005, www.researchgate.net/publication/268221528_Niacinamide’s_potent_role_in_alleviating_anxiety_with_its_benzodiazepine-like_properties_A_case_report. Accessed Aug. 2021. Niacinamide might also reduce anxiety by shunting more tryptophan toward the production of serotonin and/or by simply correcting a vitamin B3 dependency.

Publishing, Harvard Health. “Should You Take a Vitamin B12 Supplement?” Harvard Health, www.health.harvard.edu/staying-healthy/should-you-take-a-vitamin-b12-supplement. Accessed July 2020.

Rao, Naren P, et al. “Role of Vitamin B12 in Depressive Disorder — a Case Report.” General Hospital Psychiatry, vol. 30, Mar. 2008, pp. 185–186, 10.1016/j.genhosppsych.2007.09.002. Accessed June 2020. We report a case of vitamin B12 deficiency presenting with recurrent episodes of depression.

Redzic, Sasa, and Vikas Gupta. “Niacin Deficiency.” StatPearls, 20 Nov. 2021, www.statpearls.com/ArticleLibrary/viewarticle/25874. Accessed 15 Jan. 2022.

“Riboflavin.” Linus Pauling Institute, 22 Apr. 2014, lpi.oregonstate.edu/mic/vitamins/riboflavin.

Scott, Trudy. “Niacin for Anxiety and Insomnia: Andrew W. Saul on That Vitamin Summit.” Everywomanover29, May 2017, www.everywomanover29.com/blog/niacin-anxiety-insomnia-andrew-saul-that-vitamin-summit/. Accessed Jan. 2022. If you have trouble calming down or maybe difficulty sleeping at night, niacin may be worth investigating and trialing.

Shomon, Mary. “Hashimoto’s Disease-Related Fatigue and Thiamine Levels.” Verywell Health, Verywell Health, 30 Mar. 2014, www.verywellhealth.com/hashimotos-disease-fatigue-thiamine-levels-3232754.

“Signs of Vitamin B12 Deficiency.” Ada, ada.com/conditions/vitamin-b12-deficiency/. Accessed July 2020.

“Slideshow: Signs You’re Not Getting Enough Vitamin B6.” WebMD, www.webmd.com/vitamins-and-supplements/ss/slideshow-vitamins-vitamin-b6-deficiency. Accessed July 2020.

Soleymani, Teo, et al. “The Infatuation with Biotin Supplementation: Is There Truth behind Its Rising Popularity? A Comparative Analysis of Clinical Efficacy versus Social Popularity.” Journal of Drugs in Dermatology: JDD, vol. 16, May 2017, pp. 496–500, pubmed.ncbi.nlm.nih.gov/28628687/. Accessed July 2020.

Streit, Lizzie. “9 Health Benefits of Vitamin B6 (Pyridoxine).” Healthline, Healthline Media, Oct. 2018, www.healthline.com/nutrition/vitamin-b6-benefits.

“Top 10 Vitamin B12 Foods for Vegetarians.” Myfooddata, www.myfooddata.com/articles/vegetarian-vitamin-b12-foods.php. Accessed July 2020.

Tufan, Ali Evren, et al. “Mood Disorder with Mixed, Psychotic Features due to Vitamin B12 Deficiency in an Adolescent: Case Report.” Child and Adolescent Psychiatry and Mental Health, vol. 6, June 2012, 10.1186/1753-2000-6-25.

Vegan Biotin (Vitamin B7) Sources & Supplements | VeganFriendly.org.uk. www.veganfriendly.org.uk/health-fitness/vitamins/biotin/. Accessed July 2020.

“VEGETARIANS MAY NOT GET the GOOD VITAMIN B-6.” Life at OSU, Aug. 2009, today.oregonstate.edu/archives/2009/aug/vegetarians-may-not-get-good-vitamin-b-6. Accessed July 2020.

“Vitamin B-12: Functions, Deficiency, and Sources.” Www.medicalnewstoday.com, www.medicalnewstoday.com/articles/219822.

“Vitamin B1 Deficiency – Symptoms, Diagnosis and Treatment | BMJ Best Practice.” Bestpractice.bmj.com, Dec. 2021, bestpractice.bmj.com/topics/en-gb/633.

“Vitamin B2: How It Energises Your Body | Holland & Barrett.” Www.hollandandbarrett.com, www.hollandandbarrett.com/the-health-hub/vitamins-and-supplements/vitamins/vitamin-b/vitamin-b2-bodys-energy-essential/.

“Vitamin B3: What It Does, Foods, Benefits & More | Holland & Barrett.” Holland & Barrett, Feb. 2019, www.hollandandbarrett.com/the-health-hub/vitamins-and-supplements/vitamins/vitamin-b/what-does-vitamin-b3-do/. Vitamin B3 – also known as niacin – is one of the eight essential B vitamins. It helps to release energy from the food we eat, supports normal nervous system function, fights fatigue and also helps to keep your skin healthy.1.

“Vitamin B6.” Linus Pauling Institute, Apr. 2014, lpi.oregonstate.edu/mic/vitamins/vitamin-B6#inflammation. Accessed July 2020.

Vudhivai, N, et al. “Vitamin B1, B2 and B6 Status of Vegetarians.” Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, vol. 74, Oct. 1991, pp. 465–470, pubmed.ncbi.nlm.nih.gov/1797957/. Accessed July 2020.

“What Every Vegan Should Know about Vitamin B12.” The Vegan Society, 2019, www.vegansociety.com/resources/nutrition-and-health/nutrients/vitamin-b12/what-every-vegan-should-know-about-vitamin-b12.

Wikipedia Contributors. “Biotin.” Wikipedia, Wikimedia Foundation, Apr. 2019, en.wikipedia.org/wiki/Biotin.

Vitamin E – general

“A Green Monster’s Guide to Plant-Based Nutrition: Vitamin E.” One Green Planet, www.onegreenplanet.org/natural-health/plant-based-nutrition-guide-vitamin-e/. Accessed 3 July 2020.

Atli Arnarson, PhD. “20 Foods That Are High in Vitamin E.” Healthline, Healthline Media, 24 May 2017, www.healthline.com/nutrition/foods-high-in-vitamin-e#section1.

Cudmore, Dale. “The 30 Best Vegan Vitamin E Food [Data].” VegFAQs, 6 July 2018, vegfaqs.com/vegan-vitamin-e-food-sources/. Accessed 3 July 2020.

Gautam, Medhavi, et al. “Role of Antioxidants in Generalised Anxiety Disorder and Depression.” Indian Journal of Psychiatry, vol. 54, no. 3, 2012, p. 244, 10.4103/0019-5545.102424. The findings suggest that antioxidant supplement therapy as an adjuvant therapy is useful in patients with stress-induced psychiatric disorders and the results have been discussed.

“High Doses of Vitamin E Supplements Do More Harm than Good.” ScienceDaily, American Heart Association, 18 Nov. 2004, www.sciencedaily.com/releases/2004/11/041116233312.htm.

“Https://En.wikipedia.org/Wiki/Samphire.” Wikpedia, From Wikipedia, the free encyclopedia. https://en.wikipedia.org/wiki/Talk%3ASamphire.

“Https://Www.cancer.gov/Publications/Dictionaries/Cancer-Terms/Def/Alpha-Tocopherol.” Www.cancer.gov, 2 Feb. 2011, www.cancer.gov/publications/dictionaries/cancer-terms/def/alpha-tocopherol. alpha-tocopherol is fat-soluble (can dissolve in fats and oils) and is found in seeds, nuts, leafy green vegetables, and vegetable oils. Alpha-tocopherol boosts the immune system and helps keep blood clots from forming. It also helps prevent cell damage caused by free radicals (highly reactive chemicals).

Justine. “Vitamin E.” Viva! Health, 15 Aug. 2018, www.vivahealth.org.uk/a-z/vitamin-e. Accessed 3 July 2020.

MD, Uma Naidoo. “Nutritional Strategies to Ease Anxiety.” Harvard Health Blog, 13 Apr. 2016, www.health.harvard.edu/blog/nutritional-strategies-to-ease-anxiety-201604139441#:~:text=Anxiety%20is%20thought%20to%20be. Accessed 10 Mar. 2021. Anxiety is thought to be correlated with a lowered total antioxidant state. It stands to reason, therefore, that enhancing your diet with foods rich in antioxidants may help ease the symptoms of anxiety disorders. A 2010 study reviewed the antioxidant content of 3,100 foods, spices, herbs, beverages, and supplements.

“Office of Dietary Supplements – Vitamin E.” Nih.gov, 2017, ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/. Nuts, seeds, and vegetable oils are among the best sources of alpha-tocopherol, and significant amounts are available in green leafy vegetables and fortified cereals.

Publishing, Harvard Health. “Easy Does It with Vitamin E.” Harvard Health, www.health.harvard.edu/newsletter_article/Easy_does_it_with_vitamin_E.

Terada, Yuki, et al. “Increased Anxiety-like Behaviour Is an Early Symptom of Vitamin E Deficiency That Is Suppressed by Adrenalectomy in Rats.” British Journal of Nutrition, 1 June 2020, pp. 1–10, www.cambridge.org/core/journals/british-journal-of-nutrition/article/increased-anxietylike-behavior-is-an-early-symptom-of-vitamin-e-deficiency-that-is-suppressed-by-adrenalectomy-in-rats/30FE83F0CC38D4060277E55022D8B660, 10.1017/S0007114520001889. Accessed 10 Mar. 2021. Vitamin E deficiency increased anxiety-like behaviour in open arm activity, head dipping and stretch out (Fig. 2). Vitamin E refeeding significantly decreased anxiety-like behaviour in stretch out and tended to decrease them in open arm activity and head dipping (Fig. 2). Vitamin E deficiency or refeeding did not affect locomotion (Fig. 2).

“Vitamin | HSIS.” Www.hsis.org, www.hsis.org/supplements/vitamin/.

Whitbread, Daisy. “Top 10 Foods Highest in Vitamin E.” Myfooddata, My Food Data, 31 Aug. 2008, www.myfooddata.com/articles/vitamin-e-foods.php.

Nutrient depletion and nutrition

• The Weston A. Price Foundation

Soil depletion and nutrition

The importance of Colour and diversity in the diet

Aleksandra Tomova1*, Igor Bukovsky2, Emilie Rembert3, Willy Yonas3, Jihad Alwarith3, Neal D. Barnard3,4 and Hana Kahleova3. “The Effects of Vegetarian and Vegan Diets on Gut Microbiota.” The Effects of Vegetarian and Vegan Diets on Gut Microbiota, www.frontiersin.org/articles/10.3389/fnut.2019.00047/full. Additionally, vegans and vegetarians have significantly higher counts of certain Bacteroidetes-related operational taxonomic units compared to omnivores.

British Heart Foundation. “Colourful Foods.” Bhf.org.uk, British Heart Foundation, 20 July 2017, www.bhf.org.uk/informationsupport/heart-matters-magazine/nutrition/5-a-day/colourful-foods.

“Diet Diversity for Nutrition and Health.” Www.bioversityinternational.org, www.bioversityinternational.org/research-portfolio/diet-diversity/.

dminich. “6 Reasons You Need Food Diversity | Deanna Minich.” Deanna Minich, 2019, www.deannaminich.com/food-diversity/.

“Eat a Colorful Diet.” Www.rush.edu, www.rush.edu/health-wellness/discover-health/eat-colorful-diet. Accessed 14 Jan. 2022.

Hutchinson, Marley. “The Importance of Food Diversity.” Avalow, 25 Aug. 2017, medium.com/avalow/the-importance-of-food-diversity-500792af0618.

Khoury, C. K., et al. “Increasing Homogeneity in Global Food Supplies and the Implications for Food Security.” Proceedings of the National Academy of Sciences, vol. 111, no. 11, 3 Mar. 2014, pp. 4001–4006, www.ncbi.nlm.nih.gov/pmc/articles/PMC3964121/pdf/pnas.201313490.pdf, 10.1073/pnas.1313490111.

Nachvak, Seyed Mostafa, et al. “Dietary Diversity Score and Its Related Factors among Employees of Kermanshah University of Medical Sciences.” Clinical Nutrition Research, vol. 6, no. 4, 2017, p. 247, 10.7762/cnr.2017.6.4.247. Accessed 18 Feb. 2020.

Publishing, Harvard Health. “Add Color to Your Diet for Good Nutrition.” Harvard Health, www.health.harvard.edu/staying-healthy/add-color-to-your-diet-for-good-nutrition.

“The Importance of a Colorful Diet.” Winneshiek Medical Center, www.winmedical.org/our-services/clinics/family-medicine/healthy-eating/the-importance-of-a-colorful-diet/.

RDA (Recommended daily Allowance) What it means

Allowances, National Research Council (US) Subcommittee on the Tenth Edition of the Recommended Dietary. Definition and Applications. Www.ncbi.nlm.nih.gov, National Academies Press (US), 1989, www.ncbi.nlm.nih.gov/books/NBK234926/.

Harper, A. E. “Uses and Misuses of the RDA.” American Pharmacy, vol. 18, no. 11, 1 Oct. 1978, pp. 49–50, pubmed.ncbi.nlm.nih.gov/696605/. Accessed 14 Jan. 2022.

Institute of Medicine (US) Food and Nutrition Board. “What Are Dietary Reference Intakes?” Nih.gov, National Academies Press (US), 2014, www.ncbi.nlm.nih.gov/books/NBK45182/.

Nutrient Absorption difficulties

“(PDF) Bioavailability and Potential Uses of Vegetarian Sources of Omega-3 Fatty Acids: A Review of the Literature.” ResearchGate, www.researchgate.net/publication/258827155_Bioavailability_and_Potential_Uses_of_Vegetarian_Sources_of_Omega-3_Fatty_Acids_A_Review_of_the_Literature.

“Beta Carotene and Vitamin A: Can You Get Enough as a Vegan? • Renaissance Humans.” Renaissance Humans, renaissancehumans.com/beta-carotene-vitamin-can-get-enough-vegan/. Accessed 14 Jan. 2022.

Burns-Whitmore, et al. “Alpha-Linolenic and Linoleic Fatty Acids in the Vegan Diet: Do They Require Dietary Reference Intake/Adequate Intake Special Consideration?” Nutrients, vol. 11, no. 10, 4 Oct. 2019, p. 2365, 10.3390/nu11102365.

Garner BSc, MRes, PhD, Aaron. “Vegan Diets and Vitamin a Deficiency: What to Know.” Gene Food, 29 Nov. 2016, www.mygenefood.com/blog/can-vegans-get-enough-vitamin-answer-may-genetic/. Accessed 14 Jan. 2022.

Haskell, Marjorie J. “The Challenge to Reach Nutritional Adequacy for Vitamin A: β-Carotene Bioavailability and Conversion—Evidence in Humans.” The American Journal of Clinical Nutrition, vol. 96, no. 5, 10 Oct. 2012, pp. 1193S1203S, academic.oup.com/ajcn/article/96/5/1193S/4577160, 10.3945/ajcn.112.034850.

National Institute of Health. “Office of Dietary Supplements – Omega-3 Fatty Acids.” Nih.gov, 2017, ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/.

O’Leary, Fiona, and Samir Samman. “Vitamin B12 in Health and Disease.” Nutrients, vol. 2, no. 3, 5 Mar. 2010, pp. 299–316, www.ncbi.nlm.nih.gov/pmc/articles/PMC3257642/, 10.3390/nu2030299.

Pawlak, Roman, et al. “Iron Status of Vegetarian Adults: A Review of Literature.” American Journal of Lifestyle Medicine, vol. 12, no. 6, 16 Dec. 2016, pp. 486–498, www.ncbi.nlm.nih.gov/pmc/articles/PMC6367879/, 10.1177/1559827616682933.

Rizzo, Gianluca, et al. “Vitamin B12 among Vegetarians: Status, Assessment and Supplementation.” Nutrients, vol. 8, no. 12, 29 Nov. 2016, p. 767, www.ncbi.nlm.nih.gov/pmc/articles/PMC5188422/, 10.3390/nu8120767.

Vegan Vitamin a Sources & Supplements | VeganFriendly.org.uk. 15 Apr. 2019, www.veganfriendly.org.uk/health-fitness/vitamins/vegan-vitamin-a-sources-supplements/.

West, Adrian R, and Phillip S Oates. “Mechanisms of Heme Iron Absorption: Current Questions and Controversies.” World Journal of Gastroenterology, vol. 14, no. 26, 2008, p. 4101, www.ncbi.nlm.nih.gov/pmc/articles/PMC2725368/, 10.3748/wjg.14.4101.

Young, Isabel, et al. “Association between Haem and Non-Haem Iron Intake and Serum Ferritin in Healthy Young Women.” Nutrients, vol. 10, no. 1, 12 Jan. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5793309/, 10.3390/nu10010081.

Possible vegan deficiencies

Arnarson, Atli. “7 Nutrients That You Can’t Get from Plant Foods.” Healthline, 2017, www.healthline.com/nutrition/7-nutrients-you-cant-get-from-plants. However, a few nutrients are either difficult or impossible to get in adequate amounts from plant foods alone. That’s why it’s very important to be aware them and supplement your diet to maintain health or physical performance.

Barrington, Kate. “Nature’s Path Foods.” Nature’s Path, 5 July 2018, www.naturespath.com/en-us/blog/the-top-5-deficiencies-on-a-plant-based-diet/. The nutritional deficiencies that are most common with vegan and vegetarian diets include:

Collins, Clare. “If You’ve Gone Vegan, Keep an Eye out for These 4 Nutrient Deficiencies.” ScienceAlert, 2019, www.sciencealert.com/keep-an-eye-on-these-4-nutrients-if-you-ve-gone-vegan. No matter what the reason, many people find it difficult to meet the nutrient intake targets for specific vitamins and minerals while on a vegan diet. These include vitamin B12, iron, calcium, and iodine.

Craig, Winston J. “Health Effects of Vegan Diets.” The American Journal of Clinical Nutrition, vol. 89, no. 5, 11 Mar. 2009, pp. 1627S1633S, academic.oup.com/ajcn/article/89/5/1627S/4596952, 10.3945/ajcn.2009.26736n.

Medawar, Evelyn, et al. “The Effects of Plant-Based Diets on the Body and the Brain: A Systematic Review.” Translational Psychiatry, vol. 9, no. 1, 12 Sept. 2019, 10.1038/s41398-019-0552-0.

—. “The Effects of Plant-Based Diets on the Body and the Brain: A Systematic Review.” Translational Psychiatry, vol. 9, no. 1, 12 Sept. 2019, 10.1038/s41398-019-0552-0.

Rogerson, David. “Vegan Diets: Practical Advice for Athletes and Exercisers.” Journal of the International Society of Sports Nutrition, vol. 14, no. 1, 13 Sept. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5598028/, 10.1186/s12970-017-0192-9.

Sakkas, Hercules, et al. “Nutritional Status and the Influence of the Vegan Diet on the Gut Microbiota and Human Health.” Medicina, vol. 56, no. 2, 22 Feb. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7073751/, 10.3390/medicina56020088.

“UK Women at Risk from Vitamin a Deficiency.” ScienceDaily, www.sciencedaily.com/releases/2009/11/091118072051.htm. Almost half of UK women could be suffering from a lack of vitamin A due to a previously undiscovered genetic variation, scientists at Newcastle University have found.

“Vegan Deficiencies: What Are They? How Can They Be Avoided?” Www.medicalnewstoday.com, 22 Jan. 2021, www.medicalnewstoday.com/articles/vegan-defiencies. Vegan diets can have many health benefits, but they may not contain all the necessary nutrients. To avoid a deficiency, a person should be sure to consume a variety of nutritious plant-based foods and consider taking supplements.

“Vegans May Lack Essential Nutrient Intake, Study Reports.” ScienceDaily, www.sciencedaily.com/releases/2016/03/160316194551.htm.

Dehydration and the implications for mood and pain

“Mild Dehydration Impairs Cognitive Performance and Mood of Men.” The British Journal of Nutrition, vol. 106, no. 10, 2011, pp. 1535–43, www.ncbi.nlm.nih.gov/pubmed/21736786, 10.1017/S0007114511002005. Fatigue and tension/anxiety increased due to dehydration at rest (P = 0·040 and 0·029) and fatigue during exercise (P = 0·026).

Ainslie, P. N., et al. “Energy Balance, Metabolism, Hydration, and Performance during Strenuous Hill Walking: The Effect of Age.” Journal of Applied Physiology, vol. 93, no. 2, 1 Aug. 2002, pp. 714–723, 10.1152/japplphysiol.01249.2001. Accessed 17 Feb. 2021.

Armstrong, Lawrence E, et al. “Mild Dehydration Affects Mood in Healthy Young Women.” The Journal of Nutrition, vol. 142, no. 2, 2012, pp. 382–8, www.ncbi.nlm.nih.gov/pubmed/22190027, 10.3945/jn.111.142000. Accessed 21 Nov. 2019.

ArticlesPain·February 22, FeaturedNeurologyOpen Neuroscience, and 2016. “Dehydration Increases Pain Perception and Reduces Blood Flow in the Brain.” Neuroscience News, 22 Feb. 2016, neurosciencenews.com/pain-blood-flow-dehydration-3706/. https://neurosciencenews.com/pain-blood-flow-dehydration-3706/.

Bear, Tracey, et al. “A Preliminary Study on How Hypohydration Affects Pain Perception.” Psychophysiology, vol. 53, no. 5, 20 Jan. 2016, pp. 605–610, 10.1111/psyp.12610. Accessed 16 Sept. 2020. We found that hypohydration predicted increased pain sensitivity (β = 0.43), trait pain catastrophizing, and baseline pain sensitivity (β = 0.37 and 0.47, respectively). These results are consistent with previous research, and suggest that a person’s hydration status may be an important factor in their perception of acute pain.

Benton, David, and Hayley A. Young. “Do Small Differences in Hydration Status Affect Mood and Mental Performance?” Nutrition Reviews, vol. 73, no. suppl 2, 19 Aug. 2015, pp. 83–96, 10.1093/nutrit/nuv045. When dehydration reduces body mass by more than 2%, it has been consistently reported that mood is influenced, fatigue is greater, and alertness is lower.

Corney, Robert Anthony, et al. “The Effect of Hydration Status on Appetite and Energy Intake.” Journal of Sports Sciences, vol. 33, no. 8, 2015, pp. 761–768, pubmed.ncbi.nlm.nih.gov/25495101/, 10.1080/02640414.2014.962578. Accessed 14 Jan. 2022.

Ganio, Matthew S, et al. “Mild Dehydration Impairs Cognitive Performance and Mood of Men.” The British Journal of Nutrition, vol. 106, no. 10, 2011, pp. 1535–43, www.ncbi.nlm.nih.gov/pubmed/21736786, 10.1017/S0007114511002005. In conclusion, mild dehydration without hyperthermia in men induced adverse changes in vigilance and working memory, and increased tension/anxiety and fatigue.

Ganio, Matthew S. “Mild Dehydration Impairs Cognitive Performance and Mood of Men.” Citeseerx.ist.psu.edu, British Journal of Nutrition, 2011, citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.1059.2907&rep=rep1&type=pdf. Accessed 14 Jan. 2022. Matthew S. Ganio1,2, Lawrence E. Armstrong2 *, Douglas J. Casa2 , Brendon P. McDermott2 , Elaine C. Lee2 , Linda M. Yamamoto2 , Stefania Marzano2 , Rebecca M. Lopez2 , Liliana Jimenez3 , Laurent Le Bellego3 , Emmanuel Chevillotte3 and Harris R. Lieberman4 1 Texas Health Presbyterian Hospital, Institute for Exercise and Environmental Medicine, Dallas, TX 75231, USA 2 Human Performance Laboratory, University of Connecticut, Unit 1110, Storrs, CT 06269-1110, USA 3 Danone Research, R&D Waters, Palaiseau 91767, France 4 US Army Research Institute of Environmental Medicine, Military Nutrition Division, Natick, MA 01760, USA (Received 6 September 2010 – Revised 17 March 2011 – Accepted 17 March 2011 – First published online 7 June 2011).

Haghighatdoost, Fahimeh, et al. “Drinking Plain Water Is Associated with Decreased Risk of Depression and Anxiety in Adults: Results from a Large Cross-Sectional Study.” World Journal of Psychiatry, vol. 8, no. 3, 20 Sept. 2018, pp. 88–96, www.ncbi.nlm.nih.gov/pmc/articles/PMC6147771/pdf/WJP-8-88.pdf, 10.5498/wjp.v8.i3.88.

Mann, Denise. “Even Mild Dehydration May Cause Emotional, Physical Problems.” WebMD, WebMD, 20 Jan. 2012, www.webmd.com/women/news/20120120/even-mild-dehydration-may-cause-emotional-physical-problems.

Moyen, Nicole E., et al. “Hydration Status Affects Mood State and Pain Sensation during Ultra-Endurance Cycling.” Journal of Sports Sciences, vol. 33, no. 18, 2015, pp. 1962–1969, pubmed.ncbi.nlm.nih.gov/25793570/, 10.1080/02640414.2015.1021275. Accessed 14 Jan. 2022. In conclusion, dehydrated participants had greater Fatigue and Pain than euhydrated participants. These findings indicate dehydration may adversely affect mood state and perceptual ratings during ultra-endurance cycling.

Ogino, Yuichi, et al. “Dehydration Enhances Pain-Evoked Activation in the Human Brain Compared with Rehydration.” Anesthesia & Analgesia, vol. 118, no. 6, 1 June 2014, pp. 1317–1325, journals.lww.com/anesthesia-analgesia/fulltext/2014/06000/Dehydration_Enhances_Pain_Evoked_Activation_in_the.23.aspx, 10.1213/ANE.0b013e3182a9b028. Accessed 19 June 2020. Our findings suggest that dehydration brings about increased brain activity related to painful stimuli together with enhanced thirst, whereas rehydration with ORS alleviates thirst and decreases brain activity related to painful stimuli.

Popkin, Barry M, et al. “Water, Hydration, and Health.” Nutrition Reviews, vol. 68, no. 8, 20 July 2010, pp. 439–458, www.ncbi.nlm.nih.gov/pmc/articles/PMC2908954/, 10.1111/j.1753-4887.2010.00304.x. nder relatively mild levels of dehydration, individuals engaging in rigorous physical activity will experience decrements in performance related to reduced endurance, increased fatigue, altered thermoregulatory capability, reduced motivation, and increased perceived effort.

Taylor, Kory, and Elizabeth B. Jones. “Adult Dehydration.” PubMed, StatPearls Publishing, 2020, www.ncbi.nlm.nih.gov/books/NBK555956/. Often because water intake is not the most pressing topic for the average clinical visit, it is often overlooked regarding patient care. If we can encourage more healthy lifestyle choices and daily hydration, it can lead to decreased morbidity, mortality, and complications associated with dehydration.

Zhang, Na, et al. “Effects of Dehydration and Rehydration on Cognitive Performance and Mood among Male College Students in Cangzhou, China: A Self-Controlled Trial.” International Journal of Environmental Research and Public Health, vol. 16, no. 11, 1 June 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6603652/, 10.3390/ijerph16111891. As a conclusion, dehydration had negative effects on vigor, esteem-related affect, short-term memory, and attention. Rehydration after water supplementation alleviated fatigue and improved TMD, short-term memory, attention, and reaction.

Benefits of eating Organic foods

Barański, Marcin, et al. “Effects of Organic Food Consumption on Human Health; the Jury Is Still Out!” Food & Nutrition Research, vol. 61, no. 1, Jan. 2017, p. 1287333, www.ncbi.nlm.nih.gov/pmc/articles/PMC5345585/, 10.1080/16546628.2017.1287333.

Crinnion, Walter J. “Organic Foods Contain Higher Levels of Certain Nutrients, Lower Levels of Pesticides, and May Provide Health Benefits for the Consumer.” Alternative Medicine Review: A Journal of Clinical Therapeutic, vol. 15, no. 1, 1 Apr. 2010, pp. 4–12, pubmed.ncbi.nlm.nih.gov/20359265/.

Greger, Michael. “Organic versus Conventional: Which Has More Nutrients?” NutritionFacts.org, 13 Apr. 2017, nutritionfacts.org/2017/04/13/organic-versus-conventional-which-has-more-nutrients/. Based on antioxidant phytonutrient levels, organic produce may be considered 20 to 40% healthier, the equivalent of adding one or two serving’s worth to a five-a-day regimen. But organic produce may be 40% more expensive, so for the same money you could just buy the extra servings worth of conventional produce.

Meyerowitz, Steve. “Are Organic Foods More Nutritious?” Organic.org, organic.org, 24 May 2005, organic.org/are-organic-foods-more-nutritious/. There is mounting evidence that organically grown foods generate more nutrients and fewer nitrates. In a review of 400 published papers comparing organic and nonorganic foods, Soil Association Certification Ltd. Of the United Kingdom reported that organic crops were higher in essential minerals, phytonutrients, and vitamin C. Phytonutrients are plant compounds other than vitamins and minerals (such as enzymes, antioxidants, bioflavonoids).

Mie, Axel, et al. “Human Health Implications of Organic Food and Organic Agriculture: A Comprehensive Review.” Environmental Health, vol. 16, no. 1, 27 Oct. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5658984/, 10.1186/s12940-017-0315-4.

“Nutrient Levels in Organic vs. Conventional Foods.” Naturopathic Doctor News and Review, Botanical Medicine, 15 Sept. 2008, ndnr.com/botanical-medicine/nutrient-levels-in-organic-vs-conventional-foods/. Accessed 14 Jan. 2022.

Vigar, Vanessa, et al. “A Systematic Review of Organic versus Conventional Food Consumption: Is There a Measurable Benefit on Human Health?” Nutrients, vol. 12, no. 1, 18 Dec. 2019, p. 7, 10.3390/nu12010007.

—. “A Systematic Review of Organic versus Conventional Food Consumption: Is There a Measurable Benefit on Human Health?” Nutrients, vol. 12, no. 1, 18 Dec. 2019, p. 7, 10.3390/nu12010007.

Xin Zhao University of Florida Edward E Carey Reputed Agriculture 4 Development Foundation Weiqun Wang Channa Rajashekar Kansas State University. “Does Organic Production Enhance Phytochemical Content of Fruit and Vegetables? Current Knowledge and Prospects for Research.” Https://Www.researchgate.net/, Research Gate, www.researchgate.net/publication/265263313_Does_Organic_Production_Enhance_Phytochemical_Content_of_Fruit_and_Vegetables_Current_Knowledge_and_Prospects_for_Research. The evidence overall seems in favor of enhancement of phytochemical content in organically grown produce, but there has been little systematic study of the factors that may contribute to increased phytochemical content in organic crops.

The healing benefits of laughter

Louie, Dexter, et al. “The Laughter Prescription.” American Journal of Lifestyle Medicine, vol. 10, no. 4, 23 June 2016, pp. 262–267, 10.1177/1559827614550279. “However, current research is beginning to show that laughter may also have serious positive physiological effects for those who engage in it on a regular basis. Providers who prescribe laughter to their patients in a structured way may be able to use these natural, free, and easily distributable positive benefits.”

—. “The Laughter Prescription.” American Journal of Lifestyle Medicine, vol. 10, no. 4, 23 June 2016, pp. 262–267, 10.1177/1559827614550279. owever, current research is beginning to show that laughter may also have serious positive physiological effects for those who engage in it on a regular basis. Providers who prescribe laughter to their patients in a structured way may be able to use these natural, free, and easily distributable positive benefits.

Mora-Ripoll, Ramon. “The Therapeutic Value of Laughter in Medicine.” Alternative Therapies in Health and Medicine, vol. 16, no. 6, 1 Nov. 2010, pp. 56–64, pubmed.ncbi.nlm.nih.gov/21280463/. Accessed 4 Oct. 2020. ” Laughter has shown physiological, psychological, social, spiritual, and quality-of-life benefits. Adverse effects are very limited, and laughter is practically lacking in contraindications. Therapeutic efficacy of laughter is mainly derived from spontaneous laughter (triggered by external stimuli or positive emotions) and self-induced laughter (triggered by oneself at will), both occurring with or without humor.”.

Savage, Brandon M., et al. “Humor, Laughter, Learning, and Health! A Brief Review.” Advances in Physiology Education, vol. 41, no. 3, Sept. 2017, pp. 341–347, 10.1152/advan.00030.2017. Accessed 27 Mar. 2019. “oreover, humor stimulates multiple physiological systems that decrease levels of stress hormones, such as cortisol and epinephrine, and increase the activation of the mesolimbic dopaminergic reward system. To achieve these benefits, it is important to use humor that is relevant to the course content and not disparaging toward others.”

Staff, Mayo Clinic. “Stress Relief from Laughter? It’s No Joke.” Mayo Clinic, 2016, www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress-relief/art-20044456.

Strean, William B. “Laughter Prescription.” Canadian Family Physician Medecin de Famille Canadien, vol. 55, no. 10, 2009, pp. 965–7, www.ncbi.nlm.nih.gov/pmc/articles/PMC2762283/. ” Let us begin to consider that, along with eating your vegetables and getting enough sleep, laughter is a sound prescription as a wonderful way to enhance health.”.

Yoshikawa, Yuki, et al. “Beneficial Effect of Laughter Therapy on Physiological and Psychological Function in Elders.” Nursing Open, vol. 6, no. 1, 18 July 2018, pp. 93–99, 10.1002/nop2.190. ” These data strongly suggest beneficial effects of laughter therapy on physiological and psychological functions, although laughter did not affect cognitive function. The present study supports the therapeutic advantage of laughter therapy and raises the opportunity of a new approach to promote physical and mental health in older people.”.

The importance of sleep generally and in pain management

Barr, Laura. “8 Essential Vitamins and Minerals to Help You Sleep Better.” Lifehack, Lifehack, 23 May 2019, www.lifehack.org/832133/vitamins-for-sleep.

“Dietary Zinc Acts as a Sleep Modulator.” International Journal of Molecular Sciences, vol. 18, no. 11, 5 Nov. 2017, p. 2334, www.ncbi.nlm.nih.gov/pmc/articles/PMC5713303/, 10.3390/ijms18112334.

Kim, Hae Dun, et al. “Sleep-Inducing Effect of Lettuce (Lactuca Sativa) Varieties on Pentobarbital-Induced Sleep.” Food Science and Biotechnology, vol. 26, no. 3, 29 May 2017, pp. 807–814, 10.1007/s10068-017-0107-1. Accessed 9 Apr. 2020.

Lichstein, Kenneth L., et al. “Vitamins and Sleep: An Exploratory Study.” Sleep Medicine, vol. 9, no. 1, Dec. 2007, pp. 27–32, 10.1016/j.sleep.2006.12.009.

Otocka-Kmiecik, Aneta, and Aleksandra Król. “The Role of Vitamin c in Two Distinct Physiological States: Physical Activity and Sleep.” Nutrients, vol. 12, no. 12, 21 Dec. 2020, p. 3908, 10.3390/nu12123908.

—. “The Role of Vitamin c in Two Distinct Physiological States: Physical Activity and Sleep.” Nutrients, vol. 12, no. 12, 21 Dec. 2020, p. 3908, 10.3390/nu12123908.

Rondanelli, Mariangela, et al. “The Effect of Melatonin, Magnesium, and Zinc on Primary Insomnia in Long-Term Care Facility Residents in Italy: A Double-Blind, Placebo-Controlled Clinical Trial.” Journal of the American Geriatrics Society, vol. 59, no. 1, 2011, pp. 82–90, www.ncbi.nlm.nih.gov/pubmed/21226679, 10.1111/j.1532-5415.2010.03232.x.

“Vitamins to Help You Sleep | Heights.” Www.yourheights.com, www.yourheights.com/blog/sleep/vitamins-to-help-sleep. Accessed 15 Jan. 2022.

Possible vegan nutrient gaps

Arnarson, Atli. “7 Nutrients That You Can’t Get from Plant Foods.” Healthline, 2017, www.healthline.com/nutrition/7-nutrients-you-cant-get-from-plants. However, a few nutrients are either difficult or impossible to get in adequate amounts from plant foods alone. That’s why it’s very important to be aware them and supplement your diet to maintain health or physical performance.

Barrington, Kate. “Nature’s Path Foods.” Nature’s Path, 5 July 2018, www.naturespath.com/en-us/blog/the-top-5-deficiencies-on-a-plant-based-diet/. The nutritional deficiencies that are most common with vegan and vegetarian diets include:

Collins, Clare. “If You’ve Gone Vegan, Keep an Eye out for These 4 Nutrient Deficiencies.” ScienceAlert, 2019, www.sciencealert.com/keep-an-eye-on-these-4-nutrients-if-you-ve-gone-vegan. No matter what the reason, many people find it difficult to meet the nutrient intake targets for specific vitamins and minerals while on a vegan diet. These include vitamin B12, iron, calcium, and iodine.

Craig, Winston J. “Health Effects of Vegan Diets.” The American Journal of Clinical Nutrition, vol. 89, no. 5, 11 Mar. 2009, pp. 1627S1633S, academic.oup.com/ajcn/article/89/5/1627S/4596952, 10.3945/ajcn.2009.26736n.

Medawar, Evelyn, et al. “The Effects of Plant-Based Diets on the Body and the Brain: A Systematic Review.” Translational Psychiatry, vol. 9, no. 1, 12 Sept. 2019, 10.1038/s41398-019-0552-0.

—. “The Effects of Plant-Based Diets on the Body and the Brain: A Systematic Review.” Translational Psychiatry, vol. 9, no. 1, 12 Sept. 2019, 10.1038/s41398-019-0552-0.

Rogerson, David. “Vegan Diets: Practical Advice for Athletes and Exercisers.” Journal of the International Society of Sports Nutrition, vol. 14, no. 1, 13 Sept. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5598028/, 10.1186/s12970-017-0192-9.

Sakkas, Hercules, et al. “Nutritional Status and the Influence of the Vegan Diet on the Gut Microbiota and Human Health.” Medicina, vol. 56, no. 2, 22 Feb. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7073751/, 10.3390/medicina56020088.

“UK Women at Risk from Vitamin a Deficiency.” ScienceDaily, www.sciencedaily.com/releases/2009/11/091118072051.htm. Almost half of UK women could be suffering from a lack of vitamin A due to a previously undiscovered genetic variation, scientists at Newcastle University have found.

“Vegan Deficiencies: What Are They? How Can They Be Avoided?” Www.medicalnewstoday.com, 22 Jan. 2021, www.medicalnewstoday.com/articles/vegan-defiencies. Vegan diets can have many health benefits, but they may not contain all the necessary nutrients. To avoid a deficiency, a person should be sure to consume a variety of nutritious plant-based foods and consider taking supplements.

“Vegans May Lack Essential Nutrient Intake, Study Reports.” ScienceDaily, www.sciencedaily.com/releases/2016/03/160316194551.htm.

Impactful but random nutritional links

Dalton, Jane. “Certified Sustainable Palm Oil May Kill More Wildlife, Say Scientists.” The Independent, 15 Dec. 2018, www.independent.co.uk/climate-change/news/palm-oil-sustainable-certified-plantations-orangutans-indonesia-southeast-asia-greenwashing-purdue-a8674681.html.

Horton, MS, RD, Brierley. “17 Foods That Can Improve Your Mood.” LIVESTRONG.COM, 20 Mar. 2021, www.livestrong.com/article/13731421-mood-boosting-foods/. Accessed 14 Jan. 2022. Note that while these foods are associated with decreased depression and anxiety symptoms and/or overall improved mental wellness, eating these foods won’t necessarily banish depression, anxiety or other mental health conditions or symptoms. If you live with a mental health condition or are struggling, it’s important to work with a health professional as your first line of defense.

Liu, Zhibin, et al. “Prebiotic Effects of Almonds and Almond Skins on Intestinal Microbiota in Healthy Adult Humans.” Anaerobe, vol. 26, Apr. 2014, pp. 1–6, 10.1016/j.anaerobe.2013.11.007. Accessed 19 Dec. 2020. Thus we believe that almonds and almond skins possess potential prebiotic properties.

Minich, Deanna M. “A Review of the Science of Colorful, Plant-Based Food and Practical Strategies for ‘Eating the Rainbow.’” Journal of Nutrition and Metabolism, vol. 2019, 2 June 2019, pp. 1–19, www.hindawi.com/journals/jnme/2019/2125070/, 10.1155/2019/2125070. It is suggested that such a consumer-oriented categorization of these plant-based foods may lead to greater recognition of their importance in the daily diet throughout the lifespan. Other adjunctive strategies to heighten awareness of fruits and vegetables are discussed.

“Peanut Butter: Is It Good for You?” WebMD, www.webmd.com/diet/peanut-butter-good-for-you#1.

Petre MS RD, Alina, and Jillian Kubala MS RD. “6 Emerging Benefits of Poppy Seeds.” Healthline, 30 July 2020, www.healthline.com/nutrition/poppy-seeds-health-benefits.

Umesh Rudrappa. “Poppy-Seeds Nutrition Facts and Health Benefits.” Nutrition and You.com, Nutrition facts, 5 Apr. 2019, www.nutrition-and-you.com/poppy-seeds.html.

“Violent Behavior Linked to Nutritional Deficiencies.” Medical News Today, www.medicalnewstoday.com/releases/265569. Accessed 14 Jan. 2022. Deficiencies of vitamins A, D, K, B1, B3, B6, B12 and folate, and of minerals iodine, potassium, iron, magnesium, zinc, chromium and manganese can all contribute to mental instability and violent behavior, according to a report published in the Spring 2013 issue of Wise Traditions, the journal of the Weston A. Price Foundation. The article, Violent Behavior: A Solution in Plain Sight by Sylvia Onusic, PhD, CNS, LDN, seeks reasons for the increase in violent behavior in America, especially among teenagers.

Dealing with Brain fog using nutrition

“4 Nutritionist-Approved Foods to Boost Your Brain and Fight Fatig.” Healthline, 26 Oct. 2018, www.healthline.com/health/food-nutrition/brain-food-for-fatigue. Accessed 15 Jan. 2022.

“Brain Supplements: What Works, What Doesn’t.” WebMD, www.webmd.com/brain/ss/slideshow-brain-supplements.

Gandhi, Bindiya. “The Best Doctor-Approved Supplements to Beat Your Brain Fog.” Mindbodygreen, 22 Mar. 2017, www.mindbodygreen.com/0-29258/the-best-doctorapproved-supplements-to-beat-your-brain-fog.html. Accessed 14 Jan. 2022. While we know that the foods we eat can change the way we feel physically, proper supplementation can improve the gut-brain connection, leading to healthier gut and a sharper mind.

Kubala, Jillian. “6 Helpful Supplements for Brain Fog.” Healthline, 26 Aug. 2021, www.healthline.com/nutrition/vitamins-for-brain-fog. Many factors, including nutrient deficiencies or inadequacies, may contribute to brain fog symptoms.

MD, Amy Myers. “8 Nutrient Deficiencies Linked to Mood Imbalances.” Amy Myers MD, 27 Aug. 2018, www.amymyersmd.com/article/nutrient-deficiencies-mood/. Accessed 14 Jan. 2022. Did you know that your mood is closely connected to the nutrients you absorb? When patients with mood imbalances came to me for help, I always checked for nutrient deficiencies that could have been causing or contributing to the problem. Finding out what these nutrient deficiencies might be is the first step. Then you can learn the root causes of the deficiencies and begin restoring optimal levels with nutrient-rich foods and supplements such as omega-3, magnesium, vitamins B and K, and a high-quality multivitamin.

Publishing, Harvard Health. “Don’t Buy into Brain Health Supplements.” Harvard Health, www.health.harvard.edu/mind-and-mood/dont-buy-into-brain-health-supplements.

“Using Nutrition for Confidence and Self-Esteem – Nutritionist Resource.” Www.nutritionist-Resource.org.uk, www.nutritionist-resource.org.uk/articles/confidence.html.

Anxiety and Amino acids

Jones, Kristie. “Nutritional Treatments to Combat Anxiety Disorders.” Hospital News, 1 Oct. 2005, hospitalnews.com/nutritional-treatments-to-combat-anxiety-disorders/.

Klaassen, Tineke, et al. “Effects of Tryptophan Depletion on Anxiety and on Panic Provoked by Carbon Dioxide Challenge.” Psychiatry Research, vol. 77, no. 3, Feb. 1998, pp. 167–174, 10.1016/s0165-1781(98)00004-3. Accessed 21 May 2020.

Lakhan, Shaheen E, and Karen F Vieira. “Nutritional Therapies for Mental Disorders.” Nutrition Journal, vol. 7, no. 1, 21 Jan. 2008, 10.1186/1475-2891-7-2.

Lindseth, Glenda, et al. “The Effects of Dietary Tryptophan on Affective Disorders.” Archives of Psychiatric Nursing, vol. 29, no. 2, 1 Apr. 2015, pp. 102–107, www.ncbi.nlm.nih.gov/pmc/articles/PMC4393508/, 10.1016/j.apnu.2014.11.008.

Mehta, Foram. “What You Should Know about L-Theanine.” Healthline, Healthline Media, 4 Nov. 2016, www.healthline.com/health/l-theanine.

Understanding protein

“All about Protein: What Is It and How Much Do You Need?” Precision Nutrition, Precision Nutrition, 4 Apr. 2018, www.precisionnutrition.com/all-about-protein.

“Are You Getting Too Much Protein?” Https://Newsnetwork.mayoclinic.org, 2017, newsnetwork.mayoclinic.org/discussion/are-you-getting-too-much-protein/.

“Eat More Plant Proteins to Live Longer, Say Harvard Scientists.” The Vegan Society, www.vegansociety.com/whats-new/news/eat-more-plant-proteins-live-longer-say-harvard-scientists. Accessed 6 July 2020.

“Hey Vegetarians and Vegans: It’s Time to Debunk the Protein Combining Myth.” EcoWatch, 11 May 2016, www.ecowatch.com/hey-vegetarians-and-vegans-its-time-to-debunk-the-protein-combining-my-1891129518.html.

“Incomplete Proteins.” Www.umass.edu, www.umass.edu/nibble/infofile/incprot.html.

“Protein in Diet: MedlinePlus Medical Encyclopedia.” Medlineplus.gov, 2015, medlineplus.gov/ency/article/002467.htm.

“Protein in the Vegan Diet — the Vegetarian Resource Group.” Vrg.org, 2018, www.vrg.org/nutrition/protein.php.

Atli Arnarson, PhD. “8 Signs and Symptoms of Protein Deficiency.” Healthline, Healthline Media, 31 Oct. 2017, www.healthline.com/nutrition/protein-deficiency-symptoms. Even moderate protein insufficiency may cause muscle wasting, especially in elderly people.

Azzini A, Ruggeri S, Polito A. Homocysteine: Its Possible Emerging Role in At-Risk Population Groups. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073042/) International Journal of Molecular Sciences. 2020 Feb; 21(4): 1421. Accessed 5/10/2021.

Delimaris, Ioannis. “Adverse Effects Associated with Protein Intake above the Recommended Dietary Allowance for Adults.” ISRN Nutrition, vol. 2013, 2013, pp. 1–6, www.ncbi.nlm.nih.gov/pmc/articles/PMC4045293/, 10.5402/2013/126929.

Harvard Health Publishing. “The Hidden Dangers of Protein Powders – Harvard Health.” Harvard Health, Harvard Health, Sept. 2018, www.health.harvard.edu/staying-healthy/the-hidden-dangers-of-protein-powders.

https://www.facebook.com/WebMD. “Slideshow: 7 Signs You’re Not Getting Enough Protein.” WebMD, 2018, www.webmd.com/diet/ss/slideshow-not-enough-protein-signs.

March, Kate. “Protein and Vegetarian Diets | Medical Journal of Australia.” Protein and Vegetarian Diets |, Medical Journal of Australia, faunalytics.org/wp-content/uploads/2015/05/Citation2049.pdf.

Medline Plus. Homocysteine Test. (https://medlineplus.gov/lab-tests/homocysteine-test/) Accessed 5/10/2021.

Merck Manual (Professional Version). Hyperhomocysteinemia. (https://www.merckmanuals.com/professional/hematology-and-oncology/thrombotic-disorders/hyperhomocysteinemia) Accessed 5/10/2021.

Osterweil, Neil. “The Benefits of Protein.” WebMD, WebMD, 21 Apr. 2004, www.webmd.com/men/features/benefits-protein#1.

Publishing, Harvard Health. “When It Comes to Protein, How Much Is Too Much?” Harvard Health, www.health.harvard.edu/nutrition/when-it-comes-to-protein-how-much-is-too-much.

Undas A, Brozek J, Szczeklik A. Homocysteine and thrombosis: from basic science to clinical evidence. (https://pubmed.ncbi.nlm.nih.gov/16363230) Thromb Haemost. 2005 Nov;94(5):907-15. Accessed 5/10/2021.