Use of Talbinah (Barley Broth) As a Pattern of Depression Management Among Saudi Female Medical Students. Dr. Nahlaa Khalifa
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1 Use of Talbinah (Barley Broth) As a Pattern of Depression Management Among Saudi Female Medical Students Dr. Nahlaa Khalifa King Abdulaziz University Faculty of Applied Medical Sciences Clinical Nutrition Department nahlaakhalifa@outlook.com
2 OUTLINES Aim Introduction Materials & Methods 4 Results & Discussion 2
3 AIM OF THE STUDY To determine the effect of Talbinah (Barley Broth) as a prophetic evidencebased complementary medicine on depressive symptoms among Saudi medical female students. 3
4 OBJECTIVES OBJECTIVES Reviving the nutritional prophetic Sunnah by emphasising the positive effect of Talbinah on depression. Reduce the use, cost and the side effects of antidepressant medications by introducing diet in managing depression. Lead people to use evidence-based Complementary Alternative Medicine (CAM). 4 Giving more attention in combining private and public Medical care in managing mental problems. 4
5 INTRODUCTION Prevalence of Depression 8.5% Europe 3 Saudi Arabia 2 18% Developing Countries % 5
6 INTRODUCTION Prevalence of Depression
7 INTRODUCTION Depression A common mental disorder characterized by sadness, loss of interest, feeling of guilt, disturbed sleep or appetite feeling of tiredness and poor concentration. 6 Monoamine Hypothesis of Depression Pathophysiologic basis of depression is a depletion in the levels of serotonin, norepinephrine, and/or dopamine in the central nervous system. 7 7
8 INTRODUCTION Management of Depression Psychological Medical Nutritional 8
9 INTRODUCTION Management of Depression Ibn Al-Qayyim described Talbinah as a broth with the consistency of yoghurt(laban), which is made from barley flour together with husks. 8 Talbinah has the potential to reduce depression and enhance mood among elderly individuals in long term care facilities. Talbinah is a high carbohydrate food (86.4%) and has a high tryptophan, Mg,Ca and Zn level (Badrasawi et al 2013 ). 10 9
10 INTRODUCTION Carbohydrates High carbohydrate Intake increase secretion of insulin, which facilitates the transport of tryptophan in the brain and leads to higher serotonin synthesis. 11 Zn Highly depressed patients, are significantly have Low zinc serum levels. 13. Tryptophan Increase availability of tryptophan to the brain can promote sleep and restore serotonin levels that can lead to diminished depression. 12 Ca &Mg Low calcium (Ca) and magnesium (Mg) levels are linked to mental disorders such as depression. 14&15 10
11 MATERIALS & METHODS 11
12 MATERIALS & METHODS Intervention group Consumed Talbinah and habitual food for four continues weeks Non-intervention group consumed their habitual food only Post-intervention body weight, height and BMI were measured for all participants Post-intervention Beck Depression Inventory were obtained 12
13 RESULTS Sample Size Start 150 Responding 42 Remaining 37 13
14 RESULTS 14
15 RESULTS 15
16 RESULTS 16
17 RESULTS 17
18 RESULTS Effect of Talbinah on Depression score 18
19 RESULTS Talbinah Analysis 19
20 DISCUSSION 1 Significant effect of Talbinah in reducing depressive symptoms in intervention group agree with finding of Badrasawi M et.al, 10 among elderly in critical ill care. 2 Talbinah carbohydrate (68%), consider similar to Badrasawi M et.al 10, results which may have the same effect and agree with his finding on depression symptoms. 3 Talbinah protein content (14.5%), consider similar to Fernstrom J et.al 16 (brain tryptophan and serotonin levels influenced by dietary protein through effects on plasma amino acids patterns). 20
21 DISCUSSION Zn, Ca and Mg content in Talbinah may have also contributed in reducing depression. Prophetic Medicine The Significant effect of Talbinah within the intervention group agree with the facts of prophet Mohammed [peace be upon him] on the affirmative effect of Talbinah in reducing depression for sad people. Reviving the Sunnah by using prophetic medicine approach in managing depression and other chronic diseases. 21
22 LIMITATIONS Participants were not in closed control setting which result in taking different food items. Response rate was low due to limited recruitment time for the students. Recommended amount of Talbinah was not consuming on a daily basis due to unacceptable taste. Unavailability of instrument used for micronutrient analysis. 22
23 RECOMMENDATIONS Further research to be conducted in controlled settings on large number of participants. Public-Private Medical care collaboration and using of diet in managing depression Sustainable Development Goal. 3 (Good Health and well-being) Using advance technology such as MRI to detect the immediate effect of Tablinah on brain. Encourage researchers to apply studies on prophetic nutritional and evidence based alternative medicine. 23
24 REFERENCES 1. Muhammad Gadit AA, Mugford G. Prevalence of depression among households in three capital cities of Pakistan: need to revise the mental health policy. PLoS One. 2007;2(2):e Al-Khathami AD, Ogbeide DO. Prevalence of mental illness among Saudi adult primary-care patients in Central Saudi Arabia. Saudi Med J. 2002; 23(6): Ayuso-Mateos JL, Vazquez-Barquero JL, Dowrick C, Lehtinen V, Dalgard OS, Casey P, Wilkinson C, Lasa L, Page H, Dunn G, Wilkinson G. ODIN Group. Depressive disorders in Europe: prevalence figures from the ODIN study. Br J Psychiatry. 2001;179: Al-Faris EA, Irfan F, Van der Vleuten CP, Naeem N, Alsalem A, Alamiri N, Alraiyes T, Alfowzan M, Alabdulsalam A, Ababtain A et al: The prevalence and correlates of depressive symptoms from an Arabian setting: a wakeup call.2012;34 Suppl 1:S32-6. doi: / X Nahla IBRAHIM, Dania AL-KHARBOUSH, Lamis EL-KHATIB, Ahd AL-HABIB, Dana ASALI. prevalence & predictors of anxiety and depression among female medical students in King Abdulaziz University, Jeddah, Saudi Arabia. Iran J Public Health. 2013; 42(7): Published online 2013 July. 6. Al-Qadhi W, ur Rahman S, Ferwana MS, Abdulmajeed IA. Adult depression screening in Saudi primary care: prevalence, instrument and cost. BMC psychiatry. 2014; 14(1):1. 7. Bondy B.kllinik und neurobiologie:das Krankheitsbild der Depression.Pharmaize in unserer Zeit.2004:33(4); Ibn Al-Qayyim. Aljawziyya. Prophetic Medicine 9. Sahih Al- Bukhari Badrasawi MM, Shahar S, Manaf ZA, Haron H. Effect of Talbinah food consumption on depressive symptoms among elderly individuals in long term care facilities, randomized clinical trial. Clinical Interventions in Aging. 2013;8: Doi: /CIA.S Al-Qadhi W, ur Rahman S, Ferwana MS, Abdulmajeed IA. Adult depression screening in Saudi primary care: prevalence, instrument and cost. BMC psychiatry. 2014;14(1): Kravitz HM, Sabelli H, Fawcett J. Dietary supplements of phenylalanine and other amino acid precursors of brain neuroamines in the treatment of depressive disorders. The Journal of the American Osteopathic Association. 1984; 84(1 Suppl): Wójcik J, Dudek D, Schlegel-Zawadzka Mg, Grabowska M, Marcinek A, Florek E, et al. Antepartum/postpartum depressive symptoms and serum zinc and magnesium levels. Pharmacological reports. 2006; 58(4): Durlach J, Pagès N, Bac P, Bara M, Guiet-Bara A. Importance of magnesium depletion with hypofunction of the biological clock in the pathophysiology of headhaches with photophobia, sudden infant death and some clinical forms of multiple sclerosis. Magnes Res. 2004;17: Demuro A, Mina E, Kayed R, Milton SC, Parker I, Glabe CG. Calcium dysregulation and membrane disruption as a ubiquitous neurotoxic mechanism of soluble amyloid oligomers. J Biol Chem. 2005;280: Fernstrom, J. and Wurtman, R. (1971). Brain Serotonin Content: Physiological Dependence on Plasma Tryptophan Levels. Science, 173(3992), pp
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