Written by: Nurina Katta
Long-term stress can increase the risk of all kinds of adverse physical and mental health conditions, such as strokes, cardiovascular disease, emotional distress, anxiety, and depression. In addition, stress can lead to poorer lifestyle choices, including smoking, drinking, and overeating1-6.
There are high rates of stress among university students7; however, only a small number of students receive support8. Many barriers to accessing help have been identified, for example lack of time, wanting to handle issues themselves, and thinking that their struggles are not severe enough to require treatment9. These challenges highlight that for students, interventions need to be feasible and easily accessible.
Stress and micronutrient interventions
Previous studies have shown that taking vitamins and minerals (micronutrients) during or after having experienced a stressful event has positive effects on psychological functioning10-12. Research has noted nutritional supplements in particular have become more and more important in maintaining appropriate vitamin and mineral levels that support successful coping with stress. Although taking vitamin and mineral capsules is considered safe13, some people find swallowing multiple capsules difficult14. Recently, an alternative option has been developed whereby the vitamins and minerals are absorbed by the membranes lining the inside of the mouth (the oral mucosa). This bypasses the challenge for those who cannot swallow capsules or are seeking a different option.
This alternative option provides 36 vitamins and minerals in a pouch that contains a flavoured powder which is poured on or under the tongue and left there until it is dissolved. The formula contains very similar ingredients to a capsule formula that has been widely tested for the treatment of psychological symptoms; however, the doses in the powdered pouches are much lower than in the capsules – most ingredients are well below the Recommended Dietary Allowance (RDA). Absorbing the vitamins and minerals through the mouth potentially allows for this lower dose as they enter into the blood stream more directly compared to capsules (which are absorbed via the gut).
The STress Anxiety (STAR) Trial
During the lockdowns of 2020, we monitored 72 stressed students over a period of four weeks. Thirty-five students were allocated to the micronutrient group and 37 to the placebo group, and they were asked to take one powdered pouch (either vitamins and minerals or placebo) for four weeks. The participants completed various online questionnaires assessing stress, mood, emotion regulation, wellbeing, diet, and sleep. This study was the first independent randomised controlled study that looked at the effectiveness of this new way of taking vitamins and minerals as an intervention for stressed students.
What did we find?
The clinical findings were published in an APA Journal, International Journal of Stress Management.15 The results showed that this powdered vitamin and mineral option did not improve symptoms of stress better than the placebo. In both groups, the average stress scores reduced from the moderate to the mild range, with a similar number of students from both groups reducing to the normal nonclinical range (43% in the micronutrient group, 46% in the placebo group). With regards to self-rated overall improvement, at four weeks, 16.2% of the placebo group and 17.1% of the micronutrient group rated themselves as ‘much’ to ‘very much’ improved.
However, the micronutrient group showed a greater reduction in symptoms of irritability and anger compared to the placebo group. These findings align with previous research, showing that vitamins and minerals can improve emotion regulation in children and adults.16 17
Nutritional interventions have received growing attention in treating psychological symptoms, and it is important to continue to research new modes of delivery in this field. Absorbing vitamins and minerals through the mouth does not seem to be as effective in reducing stress compared to vitamin and mineral capsules at higher doses; however, if future research confirms that this method of taking vitamins and minerals can improve emotion regulation, this might represent an alternative and more convenient option for those who struggle with taking capsules. It might also be possible that because of the time of conducting the study, that is during lockdown and while students had high demands on their time, the stress was different from that experienced in the other studied events.
Note that this research was funded by the University of Canterbury and supported by a PhD scholarship from the UC Child and Well-being Research Institute. The manufacturers of the product, Truehope, did not provide any funding; however, they donated the product (EMP Lightning Sticks) and matching placebo for free for the duration of the trial.
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Written by: Nurina Katta
Photo Credit: Nathan Dumlao on Unsplash