June 21, 2012
By Marie Spano, M.S., R.D., Contributing Editor
As an antidote to today's frenetic lifestyles, food, beverages and supplements that claim to enhance relaxation have begun appearing on the market. These relaxation products have received much attention due to the regulatory status and the efficacy of the ingredients. But what is the science that supports the effects?
Chamomile has been used throughout history to make soothing infusions, and actually comes from two plant species, Matricaria recutita (German chamomile, the most-common type) and Chamaemelum nobile (Roman or English chamomile). In a randomized, double-blind, placebo-controlled study examining chamomile as a treatment for mild to moderate generalized anxiety disorder, 57 patients received either pharmaceutical-grade German chamomile extract standardized to a content of 1.2% apigenin or placebo (one capsule for the first week, two capsules daily for the second week, up to five capsules for weeks five to eight). There was a significant difference in mean Hamilton Anxiety Rating scores for those on the chamomile versus placebo (Journal of Clinical Psychopharmacology, 2009; 29:378-382). This study suggests chamomile may be beneficial for mild to moderate anxiety, though it was the first controlled trial to examine chamomile for this purpose. Chamomile has GRAS status.
Valerian is often used as a sleep aid, yet a systematic review of the most methodologically rigorous studies found no significant differences between valerian and placebo on sleep (Sleep Medicine Reviews, 2007; 11:209-230). However, valerian may attenuate anxiety when combined with other preparations. In a double-blind, placebo-controlled, randomized crossover study in 24 healthy volunteers, a 600 mg dose of lemon balm (Melissa officinalis) and valerian (Valeriana officinalis) resulted in a decrease in anxiety as rated by the Defined Intensity Stressor Simulation battery, but a 1,200 mg dose increased anxiety, indicating that the dose of the botanical may be very important (Phytotherapy Research, 2006; 20:96-102).
Valerian has also been combined with hops. In a randomized four-week study examining a combination of 500 mg valerian and 120 mg hops, 500 mg valerian only, or placebo in 30 patients with non-organic insomnia (prolonged sleep latency 30 or more minutes), valerian alone showed no effect, but the valerian-hops combination was superior to placebo for reduction of sleep latency as registered on a home recorder system (Phytotherapy Research, 2007; 21:847-851). In addition, a multicenter study that enrolled 184 adults (mean age 44.3 years), in a randomized, placebo-controlled, parallel-group study, found that two nightly tablets of standardized valerian (187 mg native extracts) and hops (41.9 mg native extracts) produced slightly greater, though nonsignificant, reductions of sleep latency relative to placebo and 25 mg diphenhydramine at the end of 14 days of treatment, and greater reductions than placebo at the end of 28 days of treatment. Quality of life was also significantly improved in the valerian-hops group relative to the placebo group at the end of the 28-day study (Sleep, 2005;28:1465-71). Valerian has GRAS status.
Lemon balm has been used as a mild sedative and sleep aid, although there are few studies on lemon balm alone. In a double-blind, randomized, crossover study, 18 volunteers received either a 300 mg or 600 mg dose of lemon balm or placebo on separate days, separated by a seven-day washout period. The 600 mg dose of lemon balm led to a significant increase in calmness, reduced self-ratings of alertness and improved mood after a Defined Intensity Stressor Simulation battery was given (Psychosomatic Medicine, 2004; 66:607-613). Another study examined 600, 1,000 and 1,600 mg doses of lemon balm or placebo in 20 healthy young participants in a randomized, placebo-controlled, double-blind crossover study. The highest dose, 1,600 mg, led to an increase in calmness (Neuropsychopharmacology, 2003; 28:1,871-1,881). Lemon balm has GRAS status.
Passion flower (passiflora) has also been used as an herbal sedative. Passion flower herbal tea enhanced sleep quality significantly compared to placebo as measured by a sleep diary in a double-blind, placebo-controlled, repeated measures study in adults 18 to 35 years of age (Phytotherapy Research, 2011; 25:1,153-1,159). Another study found passion flower extract (45 drops per day) was as effective as 30 mg per day of the prescription drug oxazepam for the treatment of generalized anxiety disorder (Journal of Clinical Pharmacy and Therapeutics, 2001; 26:363-367).
Passion flower has many active constituents, including the flavonoids apigenin, luteolin, quercetin, kaempferol and vitexin, and the harman alkaloids, including harmine, harmaline, harmalol, harman, and harmin (Fitoterapia, 2001; 72:922-926; Journal of Ethnopharmacology, 2001; 78:165-170; Chemical & Pharmaceutical Bulletin, 1974; 22:1,008-1,013).
Scientists have speculated that passion flower works by increasing levels of GABA in the brain. Some evidence suggests the constituent apigenin plays a role in the anti-anxiety effects associated with passion flower (Pharmacology Biochem and Behavior, 1997; 58:887-891). Passion flower has GRAS status.
Minerals for better moods
A few studies to date have examined the anti-anxiety potential of magnesium. In one double-blind, randomized 28-day study, a combination of magnesium, zinc and calcium improved perceived stress and reduced anxiety in healthy male volunteers compared to placebo (Psychopharmacology, 2000; 150:220-225). Additionally, 200 mg magnesium combined with 50 mg vitamin B6 resulted in a reduction of mild premenstrual anxiety symptoms compared to placebo. However, magnesium alone had no affect (Journal of Womens Health and Gender-based Medicine, 2000; 9:131-139). Magnesium has GRAS status.
Several studies, though many of poor methodological quality, indicate melatonin is not an effective sleep aid (BMJ, 2006; 332:385393). However, FDA granted orphan drug designation to melatonin for use in treating circadian sleep disorders in blind individuals with no light perception. Melatonin does not have GRAS status and is therefore considered an unapproved food additive. FDA has sent warning letters to companies that included melatonin in its beverages or that added it to conventional foods marketed as supplements.
More serenity solutions
The amino acid l-theanine increases alpha-brainwave activity, which induces relaxation (Alternative Medicine Reviews, 2005; 10:136-138). Studies show that l-theanine reduces psychological and physiological stress (Biological Psychology, 2007; 74:39-45), and it produces a dose-dependent relaxed yet alert state about 40 minutes after it is ingested. Compared with placebo, 400 mg per day l-theanine reduced anxiety and improved positive psychopathology in schizophrenia and schizoaffective disorder patients when added to ongoing antipsychotic treatment (Journal of Clinical Psychiatry, 2011; 72:34-42). In addition, 200 mg l-theanine had some relaxing effects in healthy volunteers at rest, though neither l-theanine or the prescription drug alprazolam had any effects on subjects during an induced anxiety state (Human Psychopharmacology, 1004; 19:457-465). L-theanine has GRAS status for up to 250 mg in several food categories and beverages.
Gamma-Aminobutyric acid (GABA) is an inhibitory neurotransmitter in the central nervous system (Neurology, 2012; 78(8):578-584). On a cellular level, it has sedative and anti-anxiety effects, though there is insufficient research on GABA in vivo ("Psychopharmacology: The Fourth Generation of Progress." Raven Press, Ltd., 1995). GABA does not have GRAS status.
Marie Spano, M.S., R.D., CSCS, is a nutrition communications expert whose work has appeared in popular press magazines, e-zines and nutrition-industry trade publications. She has been an expert guest on NBC, ABC and CBS affiliates on the East Coast. For more information, visit mariespano.com.
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