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Citalopram improves metabolic risk factors among high hostile adults: results of a placebo-controlled intervention.

ABSTRACT: Hostility is associated with a number of metabolic risk factors for cardiovascular disease, including waist-hip ratio, glucose, and triglycerides. Along with hostility, many of these measures have also been shown to be associated with reduced central serotonergic function. We have previously reported that a citalopram intervention was successful in reducing hostility by self-report assessment (Kamarck et al., 2009). Here we examine the effects of this serotonergic intervention on metabolic risk factors in the same sample. 159 healthy adults with elevated hostility scores were randomized to citalopram or placebo for a 2-month period. Citalopram favorably changed metabolic risk factors, including waist circumference (p=.003), glucose (p=.02), HDL cholesterol (p=.04), triglycerides (p=.03), insulin sensitivity (p=.045) and diastolic blood pressure by automated assessment (p=.0021). All of these metabolic changes were significantly mediated by treatment-related changes in body mass index (in most cases, p<.01). In addition, the changes in blood glucose were significantly mediated by treatment-related changes in hostility (p<.05). Mechanisms accounting for these associations remain to be explored.

SUBMITTER: Kamarck TW

PROVIDER: S-EPMC3118402 | biostudies-literature | 2011 Aug

REPOSITORIES: biostudies-literature

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Citalopram improves metabolic risk factors among high hostile adults: results of a placebo-controlled intervention.

Kamarck Thomas W TW Muldoon Matthew F MF Manuck Stephen B SB Haskett Roger F RF Cheong Jeewon J Flory Janine D JD Vella Elizabeth E

Psychoneuroendocrinology 20110208 7

Hostility is associated with a number of metabolic risk factors for cardiovascular disease, including waist-hip ratio, glucose, and triglycerides. Along with hostility, many of these measures have also been shown to be associated with reduced central serotonergic function. We have previously reported that a citalopram intervention was successful in reducing hostility by self-report assessment (Kamarck et al., 2009). Here we examine the effects of this serotonergic intervention on metabolic risk ...[more]

PMID: 21306829

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Project description:Objective To assess the effectiveness of citalopram for major depressive disorder (MDD) in adults, in a systematic review of all published, randomised, double-blind studies comparing it with a placebo. Data sources Cochrane Central Register of Controlled Trials, Medline, PsychINFO and Embase. Study selection Randomised, double-blind, placebo-controlled studies of citalopram in adults with MDD were included. Studies with medically ill or treatment resistant subjects were excluded, as were studies of relapse prevention. Remission of MDD was defined as a primary outcome, and response or change from baseline scores were defined as secondary. Data extraction Remission, response and symptom improvement scores on the Hamilton Depression Scale, Montgomery-Asberg Depression Rating Scale and Clinical Global Impressions-Severity scales were extracted. A random-effects meta-analysis was carried out on the response rates and symptom improvement scores. Included studies were examined for the presence of bias and small study effects. Results Eight studies (n=2025) met the inclusion criteria. Two studies provided data on remission, but only one of these showed a significant difference between citalopram and placebo (RR=1.59, 95% CI 1.10 to 2.31). Meta-analysis of response rates in five studies (n=1010) revealed significant superiority of citalopram (RR=1.42, 95% CI 1.17 to 1.73). Meta-analysis of change from baseline scores in five studies (n=1541) gave a standardised mean difference (Hedges' g) of -0.27 (95% CI -0.38 to to -0.16), showing a reduction in MDD symptoms to be significant for citalopram relative to placebo. There was no evidence of any significant small study effects. The overall quality of reporting was poor, with insufficient information on the methodology or outcomes. Seven studies received industry sponsorship. Conclusions Data concerning remission rates for citalopram, relative to placebo, are inconclusive. Response rates and symptom reduction scores in citalopram-treated patients with MDD are significantly better relative to placebo treatment, according to a meta-analysis of published reports. Evaluation of unpublished data is necessary to assess more definitively the effectiveness of citalopram for MDD.

Project description:BackgroundHigh sugar and refined carbohydrate intake is associated with weight gain, increased incidence of diabetes and is linked with increased cardiovascular mortality. Reducing the health impact of poor quality carbohydrate intake is a public health priority. Reducose, a proprietary mulberry leaf extract (ME), may reduce blood glucose responses following dietary carbohydrate intake by reducing absorption of glucose from the gut.MethodsA double-blind, randomised, repeat measure, phase 2 crossover design was used to study the glycaemic and insulinaemic response to one reference product and three test products at the Functional Food Centre, Oxford Brooks University, UK. Participants; 37 adults aged 19-59 years with a BMI ≥ 20kg/m2 and ≤ 30kg/m2. The objective was to determine the effect of three doses of mulberry-extract (Reducose) versus placebo on blood glucose and insulin responses when co-administered with 50g maltodextrin in normoglycaemic healthy adults. We also report the gastrointestinal tolerability of the mulberry extract.ResultsThirty-seven participants completed the study: The difference in the positive Incremental Area Under the Curve (pIAUC) (glucose (mmol / L x h)) for half, normal and double dose ME compared with placebo was -6.1% (-18.2%, 5.9%; p = 0.316), -14.0% (-26.0%, -2.0%; p = 0.022) and -22.0% (-33.9%, -10.0%; p<0.001) respectively. The difference in the pIAUC (insulin (mIU / L x h)) for half, normal and double dose ME compared with placebo was -9.7% (-25.8%, 6.3%; p = 0.234), -23.8% (-39.9%, -7.8%; p = 0.004) and -24.7% (-40.8%, -8.6%; p = 0.003) respectively. There were no statistically significant differences between any of the 4 groups in the odds of experiencing one or more gastrointestinal symptoms (nausea, abdominal cramping, distension or flatulence).ConclusionsMulberry leaf extract significantly reduces total blood glucose rise after ingestion of maltodextrin over 120 minutes. The pattern of effect demonstrates a classical dose response curve with significant effects over placebo. Importantly, total insulin rises were also significantly suppressed over the same time-period. There were no statistically significant differences between any of the treatment groups (including placebo) in the odds of experiencing one or more gastrointestinal symptoms. Mulberry extract may have multiple modes of action and further studies are necessary to evaluate ME as a potential target for the prevention of type 2 diabetes and the regulation of dysglycaemia.

Project description:BackgroundDefatted rice bran (DRB) is a byproduct of rice bran oil production rich in fiber, protein, and antioxidant compounds that may confer beneficial effects on metabolic profiles in humans. The current study aimed to investigate the effects of DRB supplementation on anthropometric and blood biochemical indices, dietary intake, and inflammatory status in overweight/obese subjects with hypercholesterolemia.MethodsIn a 12-week-randomized placebo-controlled trial, 61 overweight/obese participants with a total cholesterol level > 200 mg/dL were randomly assigned either to 30 g/d DRB (n = 30) or to 10 g/d maltodextrin (n = 31).ResultsDRB intervention significantly reduced systolic and diastolic blood pressure by 4.27 and 4.50%, respectively (126.20 ± 13.63 to 120.60 ± 13.72 mmHg, p = 0.0003 and 80.87 ± 7.38 to 77.17 ± 9.83 mmHg, p = 0.0035). HbA1c also decreased significantly by 3.59% (5.89% ± 0.76% to 5.66% ± 0.62%, p = 0.0001) after DRB supplementation. Total cholesterol, triglyceride, and low-density lipoprotein cholesterol levels also decreased insignificantly by 3.12, 1.32, and 1.53%, respectively, after DRB supplementation. Insignificant differences in fasting blood glucose, insulin, homeostatic model assessment of insulin resistance, quantitative insulin sensitivity check index, hs-CRP and homocysteine levels were also observed after DRB intervention. Reduction in caloric and fat intake were reported in DRB groups.ConclusionsDRB supplementation improved blood pressure and HbA1c levels. It also lowered blood cholesterol, albeit insignificantly. Caloric and fat intake were also significantly lower after DRB supplementation. Further study is needed to evaluate the mechanisms by which DRB improves these metabolic indices.Trial registrationThai Clinical Trial Registration ( https://www.thaiclinicaltrials.org/. ) Thai Clinical Trial Registration number: TCTR20191020003. Registered 20 October 2019.

Project description:BackgroundAn inadequate protein intake may offset the muscle protein synthetic response after physical activity, reducing the possible benefits of an active lifestyle for muscle mass. We examined the effects of 12 weeks of daily protein supplementation on lean body mass, muscle strength, and physical performance in physically active older adults with a low habitual protein intake (<1.0 g/kg/day).MethodsA randomized double-blinded controlled trial was performed among 116 physically active older adults [age 69 (interquartile range: 67-73) years, 82% male] who were training for a 4 day walking event of 30, 40, or 50 km/day. Participants were randomly allocated to either 31 g of milk protein or iso-caloric placebo supplementation for 12 weeks. Body composition (dual-energy X-ray absorptiometry), strength (isometric leg extension and grip strength), quadriceps contractile function, and physical performance [Short Physical Performance Battery, Timed Up-and-Go test, and cardiorespiratory fitness (Åstrand-Rhyming submaximal exercise test)] were measured at baseline and after 12 weeks. We assessed vitamin D status and markers of muscle damage and renal function in blood and urine samples before and after intervention.ResultsA larger increase in relative lean body mass was observed in the protein vs. placebo group (∆0.93 ± 1.22% vs. ∆0.44 ± 1.40%, PInteraction = 0.046). Absolute and relative fat mass decreased more in the protein group than in the placebo group (∆-0.90 ± 1.22 kg vs. ∆-0.31 ± 1.28 kg, PInteraction = 0.013 and ∆-0.92 ± 1.19% vs. ∆-0.39 ± 1.36%, PInteraction = 0.029, respectively). Strength and contractile function did not change in both groups. Gait speed, chair-rise ability, Timed Up-and-Go, and cardiorespiratory fitness improved in both groups (P < 0.001), but no between-group differences were observed. Serum urea increased in the protein group, whereas no changes were observed in the placebo group (PInteraction < 0.001). No between-group differences were observed for vitamin D status, muscle damage, and renal function markers.ConclusionsIn physically active older adults with relatively low habitual dietary protein consumption, an improvement in physical performance, an increase in lean body mass, and a decrease in fat mass were observed after walking exercise training. A larger increase in relative lean body mass and larger reduction in fat mass were observed in participants receiving 12 weeks of daily protein supplementation compared with controls, whereas this was not accompanied by differences in improvements between groups in muscle strength and physical performance.

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Citalopram improves metabolic risk factors among high hostile adults: results of a placebo-controlled intervention.

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Citalopram improves metabolic risk factors among high hostile adults: results of a placebo-controlled intervention.

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