The reviews this month are an attempt to connect the dots between PNIE and other holistic areas of interest including behavior, exercise and nutrition

Townsend Letter for Doctors and Patients, Dec, 2003 by Robert A. Anderson

Mortensen EL, Michaelsen KF, Sanders SA et al. The association between duration of breast feeding and adult intelligence. JAMA 2002 May 8; 287(18):2365-71.

COMMENT: This may be a bit far afield, but it is worth knowing the connection between breast feeding and intelligence. This may be a public health issue as well. In these two independent samples of young adults, adult intelligence was positively associated with length of breast feeding. Many studies have linked lower intelligence and education levels to greater risk for degenerative disease. All health professionals and those in the helping professions should reinforce in diverse ways the benefits of breast feeding. A significant majority of expectant mothers might be persuaded to breast feed if they knew their kids would probably be more intelligent. The mechanisms of this association may be the lack of important essential fatty acids in cow's milk formulas when substituted for breast feeding.

Depression and eicosapentaenoic acid

Countries with high rates of fish oil consumption have low rates of depression. The authors studied eicosapentaenoic acid as adjunctive treatment for patients with recurrent unipolar depressive disorder who were on maintenance antidepressant drugs. In 20 patients with major depressive disorder, mean age 53, mean Hamilton Depression scores at 2, 3, and 4 weeks fell 12.4 points in those randomized to take 1 g of EPA b.i.d. for 4 weeks vs. a drop of 1.6 in placebo patients (p<0.001) evaluated in double-blind fashion. Antidepressant drugs were continued. No side effects were encountered.

Nemets B, Stahl Z, Belmaker RH. Addition of omega-3 fatty acid to maintenance medication treatment for recurrent unipolar depressive disorder. Am J Psychiatry 2002 Mar; 159(3):477-9

COMMENT: This adjunctive approach to antidepressant therapy is very welcome. Depression is common. The currently popular therapy for depression involves antidepressant drugs, often unaccompanied with any cognitive or proactive behavioral treatment. So the treatment fails to involve any expenditure of effort to ferret out the cause of the depression, much less deal with it. This is piecemeal treatment and unlikely to evoke any permanent change. In this study, adding EPA to the pharmacological treatment enhanced the progress in depressed patients. No downside, so why not use it? One wonders what cognitive/growth-oriented psychotherapy plus EPA might do.

Cognitive performance and marijuana

This study evaluated comparative performance on nine standard neuropsychological tests assessing attention, memory, and executive functioning in 102 near-daily cannabis users (51 long-term users: mean, 24 years of use; 51 shorter-term users: mean, 10 years of use) and 33 nonuser controls. Long-term users recalled significantly fewer words than either shorter-term users (p=0.001) or controls (p=0.005); there was no difference between shorter-term users and controls. Long-term users showed impaired learning (p=0.007), retention (p=0.003), and retrieval (p=0.002) v. controls. Both user groups performed poorly on a time estimation task (p<0.001 vs. controls).