Dr John Briffa: Sunny side up

Not many of us relish the shorter days and long nights the winter months bring. However, for sufferers of seasonal affective disorder - Sad - the darkened skies that accompany this time of year are viewed with dread. Sad, a depressive condition triggered by low levels of sunlight, affects more than a million Britons, while a more muted version of the condition, sub-syndromal Sad, or winter blues, afflicts millions more. For sufferers, lack of sunlight can go way beyond low mood and melancholy; fatigue, unrefreshing sleep, carbohydrate cravings, weight gain and loss of libido are also common side-effects.

Sad and sub-syndromal Sad are believed to be the result of alterations in brain chemistry related to less than optimal levels of sunlight exposure. No wonder, then, that studies have shown that increasing light exposure is effective in lifting mood. Exposure to light at a brightness of 2,500 lux (lux is the standard unit of measurement for brightness) has the capacity to brighten our outlook within three to four days, and this effect is sustained provided treatment is continued daily. The light intensity in a typical house is 100 lux or less, 300-500 in the workplace. What this means is that getting up and coming home in the dark, as many of us do in the depths of winter, puts us at risk of Sad or sub-syndromal Sad.

Getting out and about in the winter offers a ray of hope for those prone to light-related depression. Even the dullest of days offers about 2,000 lux of light, increasing to 10,000 lux or so when the sun shines. Increasing light exposure has been shown to help not just mood, but other features of Sad and sub-syndromal Sad, too. A recent study found that light treatment significantly decreased depression ratings and improved mood, energy, alertness and productivity scores in a typical workplace setting. Another study found that bright light improved vitality and mood among individuals working indoors in the wintertime, even in those not suffering from Sad.

Another strategy that is useful for uplifting mood in winter is exercise. Research shows that exercise alone is as effective as bright light in relieving depressive symptoms. Other studies have found that exercise is significantly more effective at alleviating other symptoms of Sad and sub-syndromal Sad when combined with bright-light exposure.

As regards diet, sufferers of Sad or sub-syndromal Sad should eat oily fish, such as salmon, trout, and mackerel, as the omega-3 fatty acids present in these fish seems to balance brain chemistry and protect against depression. A natural remedy to consider is the medicinal herb Hypericum perforatum (St John's Wort), which studies suggest can be effective in combating the symptoms of Sad.

For those prone to the winter blues, the good news is that simple lifestyle adjustments can help bring the sunshine back into their lives.

Nutrition news

Several studies suggest that eating more nuts is associated with a reduced risk of heart disease. However, nuts are intensely calorific on account of their high fat content and are therefore generally regarded as a fattening food.

To test this, scientists fed individuals 50g (the equivalent of 320 calories) of almonds every day for a period of six months to see what effect, if any, this had on their weight. During the almond-feeding period, the average weight gain for each individual was 1lb, a small increase that was not statistically significant. Not only this, but those who experienced this weight gain tended to be overweight before the experiment began. Food diaries and interviews with those who took part in the study revealed that when they increased their consumption of nuts, they automatically compensated for this by eating less of other foods. The results suggest that the notion that nuts are an inherently fattening food is therefore unfounded.

Dear John

I have a problem with chilblains that affect several of my toes in the colder weather. Can you recommend anything that might help?
Joan Carver, Newport, Gwent

Chilblains are itchy, purple-red swellings that usually occur on the toes. They are caused by excessive narrowing and constriction of the blood vessels as a result of exposure to the cold. They occur mostly in the young and the elderly, and are more common in women than men.

Keeping your toes warm with thick socks and suitable footwear is an obvious precaution. There are also a number of natural remedies that can help improve the circulation to your feet and toes.

One nutrient that might help is vitamin E. This reduces the stickiness of platelets in the blood, thereby thinning the blood and improving circulation. Take 400-800iu per day.

A magnesium supplement may also help, as it has a relaxant effect on blood vessels. Take 250-500mg per day.

Finally, the herb ginkgo biloba can also provide relief, as it is well known in natural medicine for its ability to improve the circulation. The usual recommended dose is 60-120mg of standardised extract taken twice daily.

Thanks to guardian.co.uk who have provided this article. View the original here.


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