Presenter of 2 Presentations
FEASIBILITY STUDY FOR CONDUCTING A RANDOMIZED, CONTROLLED TRIAL OF THE ADJUNCTIVE USE OF MICRONUTRIENTS FOR PATIENTS WITH BIPOLAR DISORDER
Abstract
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1. Background and purpose: Uncontrolled, non-randomized studies have shown pre-and post-intervention improvements in patient-reported symptoms for bipolar disorder in association with supplementation with micronutrients and fish oil. This feasibility study aimed to guide a larger randomized, controlled trial in a rural primary care residency training clinic in the northeastern United States.
2. Methods: Patients were recruited with a confirmed diagnosis of bipolar disorder, either type. Baseline questionnaires were administered. Patients were randomized to active or placebo conditions in a 3:2 ratio. They were begun on 2 capsules twice daily of a micronutrient formula with 35 ingredients (details at www.truehope.com) (or a placebo containing riboflavin to turn their urine yellow) plus Wylie’s Alaskan Finest Fish Oil at a dose of 2.1 gm of eicosapentaenoic acid (EPA) acid daily (or olive oil placebo). The dose of micronutrients was increased monthly until a final dose of 8 capsules twice daily was achieved at the beginning of month 4. Questionnaires were administered monthly.
3. Results: One hundred twenty participants were randomized, and 50 continued for 4 months. Only 2 patients continued to 12 months. Of those who provided four months of data, statistically significant improvement occurred on the Clinical Global Impressions Scale (CGI) and the Basis-24 patient rating scale. On the My Medical Outcomes Profile version 2 (MYMOP2), treated patients reported greater improvement than untreated patients.
4. Conclusions: While patients improved when they took the supplements, patients were not able to continue to the one year mark. Future studies need patients’ physicians to be more directly involved in supporting compliance with the protocol.
EFFECT OF CULTURAL INTERVENTIONS ON DIABETES MANAGEMENT AMONG INDIGENOUS NORTH AMERICANS
Abstract
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1. Background and purpose: With the help of traditional cultural elders, we implemented a cultural intervention for indigenous people with diabetes that lasted for one year.
2. Methods: The traditional elders told stories, talked about traditional approaches to health and disease, and performed ceremonies. An indigenous nutritionist prepared traditional foods and discussed the traditional diet. Others led craft-making on occasion. The goal was to enhance participants' spiritual and cultural fluency and to determine what impact this intervention had on their diabetes. We reviewed the narratives for commonalities and themes using several narrative analysis, modified grounded theory, and dimensional analysis and grouped the themes, We compared pre-and post-levels of hemoglobin A1C.
3. Results: The more powerful and life-changing the spiritual transformation was, the more likely diabetes was to improve or even disappear. Common themes included people becoming more present-centered; feeling higher quality in their relationships; feeling more connected to God, Creator, Nature, or Higher Power; feeling more peaceful; feeling more accepting of death and change, and having a greater sense of meaning and purpose. People began to eat more traditional diets (which were better for diabetes than the diets they had been eating) and to be more active. They were not doing this to improve diabetes, but were doing so in order to be more traditional and to honor their heritage. Hemoglobin A1C levels from before the intervention to afterward statistically significantly decreased.
4. Conclusions: For indigenous people, approaches emphasizing culture and tradition may be more effective in improving diabetes control than more direct approaches that emphasize conventional health education.