Abstract
Background
Mental health challenges, including anxiety, stress, depression, sleep disturbance and cognitive deficits, are prevalent among athletes due to continuous overtraining or field stress. Pearl millet is a nutrient-dense grain rich in lipids, iron, dietary fibre, and B vitamins and has potential benefits for mental well-being and improved cognitive function. Hence, the present randomised controlled trial aimed to study the effects of pearl millet diet on serum micronutrient status, mental health (anxiety, depression, and sleep disturbance and disordered eating behaviour) and meta-cognitive skills in athletes.
Methods
Male athletes (n = 60) aged 18–25 years were randomly allocated to experimental (EG) or control (CG) groups. The EG was provided with 1/3 of a pearl millet diet in lieu of regular cereals (wheat/rice) for 60 days, and the CG continued with a regular diet. Pre- and post-test blood samples were collected for biochemical analysis (haemoglobin (Hb), serum ferritin, folate and vitamin-B12); mental health and meta-cognitive skills were determined via the SMHAT-1 and MCSS, respectively. The effects of the pearl millet diet on the study outcomes were determined via paired and independent sample t tests.
Results
Compared with the CG, the EG significantly decreased (p = 0.014) disordered eating behaviour and significantly improved meta-cognitive skills in planning (p < 0.046), monitoring (p < 0.041), evaluation (p = 0.024) and total MCSS (p = 0.020). Hb (p = 0.016) and serum vitamin B-12 significantly (p = 0.052) increased in the EG, but the mean difference between the EG and CG was significant for folate (p = 0.031) and Hb (p = 0.003).
Conclusion
Pearl millet diet decreases the risk of disordered eating, and improves meta-cognitive skills and haemoglobin, micronutrient status in terms of folate and vitamin B-12 in athletes.
Keywords: Athletes, Pearl millet, Mental health, Meta-cognitive skills, Vitamin B12, Folate, Ferritin
Introduction
Athletes' physical and mental health is crucial for overall well-being and performance excellence [1]. Mental health encompasses emotional stability, stress management, and overall well-being [2], whereas metacognitive skills involve an individual’s ability to understand and analyse their own cognitive capabilities [3].
The athletic population is particularly vulnerable to mental health disorders such as anxiety, depression, posttraumatic stress, sleep and eating disorders due to the intense pressures of training and competition [4]. Negative life events, such as injuries, performance failures, retirement, or career dissatisfaction, increase the risk of mental health issues [5]. Stress can lead to structural changes in the prefrontal cortex, a brain region essential for cognitive skills such as decision-making and emotional regulation [6]. Tomczyk demonstrated that anxiety in collegiate athletes slowed down both simple and complex reaction times before and after competitions [7].
Athletic performance requires cognitive function in equal measure since it directly determines decision-making, reaction time, concentration, and problem-solving ability. In competitive sports, athletes use cognitive skills for rapid information processing, for strategy adaptation in the heat of play, and for sustaining focus under excessive pressure [8]. To illustrate, recognition-primed decision-making and ecological dynamics are key in team sports such as football or basketball, while attentional sustainment is critical in endurance sports [9]. Chronic stress [10], anxiety [11], depression [12], sleep disturbances [13], and nutrient deficiency [14] can hinder cognitive performance. The provision of good nutrition, recovery training, and stress management enhances cognitive skills, allowing athletes to focus better, work as a team, and achieve improved performance results [8, 15].
The application of psychotherapy alone does not always help in treating mental health disorders. Optimum nutrition plays an important role in regulating mood, reducing stress, and enhancing cognitive performance [16, 17]. Nutrients such as eicosapentaenoic acid, docosahexaenoic acid, alpha-tocopherol, magnesium and folic acid have beneficial effects on stress, sleep disorders, anxiety, and mild cognitive impairment [18]. Vitamins B6 and B12 improve nerve function, muscle control, and pain regulation [19]. Folate is converted into l-methyl folate, which supports the production of neurotransmitters, such as dopamine, norepinephrine, and serotonin, which help to regulate motivation, control stress responses and help improve mood and sleep quality, respectively [18]. Vitamin B12 potentially plays a role in the development of the myelin sheath, which protects nerve fibres, which are essential for the transmission of signals for memory and focus. It also helps in regulating homocysteine levels, which reduce neurotoxicity, help improve mood and emotional stability and improve cognitive function [19]. Deficiencies in B vitamins lead to megaloblastic anaemia and neurological symptoms such as depression, cognitive decline, and dementia [20], highlighting the critical role of B vitamins in brain function.
Pearl millet is nutrient dense and contains essential vitamins, minerals, and bioactive compounds that explicitly or implicitly influence brain health. It is a rich source of micronutrients such as B vitamins, iron, magnesium, calcium and phosphorous [21]. Pearl millet is rich in iron [21], which is involved in brain oxygen transportation, DNA synthesis, mitochondrial respiration, myelin synthesis, and neurotransmitter synthesis and metabolism [22]. Deficiency of oxygen in the brain, known as cerebral hypoxia, affects cognitive function, such as attention, learning and memory [23]. Iron deficiency profoundly affects impaired cognition, mood, depression, and physical performance [24, 25]. Pearl millet has high magnesium content, which helps reduce depression [26] and mitigates the impact of stress hormones.
The amino acid content of pearl millet helps maintain neuron health and supports memory [27]. Pearl millet has a high fibre content [21] and a low glycaemic index, which helps slow the release of glucose and helps sustain mental focus and productivity [28]. It also contains abundant phenolic compounds, flavonoids, and antioxidants to protect against oxidative stress-induced cognitive impairment and improve mental health [29]. Alpha-tocopherol (vitamin E) is an antioxidant that helps to protect cell membranes, and its deficiency leads to neurological problems [30]. The fatty acid profile of pearl millet reveals that omega-3 fatty acids, which are essential for the central nervous system and help improve sleep quality, have anti-inflammatory qualities that aid in brain development and cognitive function [31].
Thus, a nutritious diet affects brain composition, structure, and function, as well as hormones, neuropeptides, neurotransmitters, and the micro biota‒gut‒brain axis, all of which play critical roles in stress management, inflammation, and cognitive preservation [17].
Nutrition is a modifiable factor that can influence mental health, and meta-cognitive development in athletes’ feeding habits constitutes the most promising and effective measure to overcome nutritional problems among athletes. This study aims to address this gap by investigating the effects of pearl millet supplementation on serum micronutrient status, mental health and meta-cognitive skills in athletes. Macro- and micronutrients affect both the mental and meta-cognitive skills of individuals. This study focuses on the targeted impact of pearl millet diet on serum vitamin B12, folate, and ferritin status, providing research-based insights into optimising dietary strategies for enhanced athletic and cognitive performance.
Methods
Study participants
One hundred male participants, performance level 3 (PL3: > 5 h/week) [32] aged between 18 - 25 years who were receiving training in the preparatory phase screened, following the inclusion and exclusion criteria. The investigators reached the participants through sports academies and their coaches. The inclusion criteria were good health, a willingness to participate either following the trial guidelines (e.g., avoid potentially conflicting nutritional or vitamin supplements) or providing notification of compliance. The exclusion criteria included consumption of millet, alcohol, smoking, recent history of acute or chronic debilitating illness, medication, consumption of dietary supplements and ergogenic aids, physical disabilities and the presence of sports injuries.
A sample size was calculated by G-power (3.1.9.4, Germany), assuming a 2-tailed 5% type I error rate and 90% power, which showed that a sample size of 44 would be sufficient to measure the study outcomes, adding a 30% dropout rate, the estimated sample size was 57. However, the study included 60 participants to maintain an equal number of participants in the study groups, i.e., 30 in each group.
On the basis of initial screening (n = 60), participants were recruited for the study and randomly assigned to the control (n = 30) and experimental groups (n = 30). The mean height (cm), weight (kg), body fat % (BF), and fat-free mass (FFM) (kg) were 173.0 ± 6.08, 66.1 ± 10.30, 18.1 ± 4.68, and 51.0 ± 5.89, respectively.
Institutional Ethical Committee: The trial protocol was approved by the Institutional Ethical Committee. All the procedures were followed in accordance with the guidelines of the Declaration of Helsinki. The participant’s free and informed consent was taken.
Study design
The study was conducted in three phases (Fig. 1).
Fig. 1.
Study protocol
First phase: Participants (n = 60) who were receiving training in the preparatory phase on the basis of the inclusion and exclusion criteria were recruited. The participants were asked to refrain from exercise in the previous 24 h and report to the laboratory after 8–12 h of fasting on the day of the experiment. A fasting blood sample was taken for biochemical assessment (haemoglobin, serum vitamin B12, folate and ferritin) by a trained laboratory technician. Then, anthropometry and body composition data were taken on an empty stomach via a standardised protocol. After the measurements, the participants were given ad libitum rice and wheat-based diet. In the well-fed state, mental health and meta-cognitive skills questionnaires were completed in one-to-one sessions. The data were collected by a well-trained investigator to assess nutritional behavioural aspects. After the pre-test data collection, the participants were randomly distributed into two groups, i.e., CG (n = 30) and the Pearl Millet diet group EG (n = 30).
Second phase: The EG was provided with a pearl millet diet, replacing 1/3rd of the daily cereal with pearl millet recipes provided during the intervention phase. The average nutrient intake of 3 days dietary information was used to calculate the amount of pearl millet in the diet (1/3 instead of regular cereals). The nutritional profile of pearl millet and wheat based diet were showed in Table 1. Weekly days included pearl millet-based Roti (Unleavened flat bread), Uttappam (breakfast recipe), Poha (breakfast recipe), Paratha (Unleavened flat bread), Tikki (Indian Snack), Crispy balls (Indian Snack), Cheela (breakfast recipe), Chocolate Shake, Mango Shake, and Vanilla Shake. The weekends included pearl millet Puffs, pearl millet Ladoo (traditional sweet), pearl millet Mathi (traditional snack), and pearl millet Bounty Bars; these foods were packed hygienically and provided to the participants.
Table 1.
Cereal nutritional composition of regular and pearl millet based diets
| Name of the nutrient | Regular diet | Pearl millet diet | |
|---|---|---|---|
| Energy & Proximate analysis | Energy (Kcal) | 990 | 1016 |
| Carbohydrate (g) | 201.5 | 198.6 | |
| Protein (g) | 31.0 | 31.4 | |
| Total fat (g) | 4.1 | 8.0 | |
| Total dietary fibre (g) | 30.7 | 30.1 | |
| Insoluble dietary fibre (g) | 26.1 | 25.6 | |
| Soluble dietary fibre (g) | 4.5 | 5.3 | |
| Total available carbohydrate (g) | 186.5 | 183.2 | |
| B-Vitamins | Thiamine (mg) | 1.2 | 1.0 |
| Riboflavin (mg) | 0.4 | 0.5 | |
| Niacin (mg) | 7.7 | 5.9 | |
| Pantothenic acid (mg) | 3.1 | 2.5 | |
| Pyridoxine (mg) | 0.73 | 0.74 | |
| Biotin (µg) | 2.95 | 2.56 | |
| Total folates (µg) | 82.9 | 88.9 | |
| Minerals | Calcium (mg) | 106.5 | 94.5 |
| Iron (mg) | 10.7 | 13.2 | |
| Magnesium (mg) | 336.5 | 335.5 | |
| Selenium (SE) [mgs] | 126.0 | 108.7 | |
| Zinc (ZN) [mgs] | 8.0 | 7.9 | |
| Fatty acids | Capric C10:0 (mg) | 0.34 | 0.34 |
| Myristic C14:0 (mg) | 5.28 | 5.27 | |
| Palmitic C16:0 (mg) | 520.1 | 1073.1 | |
| Stearic C18:0 (mg) | 44.8 | 158.0 | |
| Arachidic C20:0 (mg) | 0.58 | 18.8 | |
| Behenic C22:0 (mg)] | 0.79 | 0.79 | |
| Lignoceric C24:0 (mg) | 0.45 | 0.46 | |
| Palmitoleic C16:1 (mg) | 0.59 | 7.56 | |
| Oleic C18:1n9 (mg) | 414.4 | 1313.4 | |
| Eicosenoic C20:1n9 (mg) | 0.62 | 0.61 | |
| Nervonic C24:1n9 (mg) | 0.3 | 0.3 | |
| Linoleic C18:2n6 (mg) | 1713.7 | 2941.7 | |
| α-Linolenic C18:3n3 (mg) | 105.1 | 206.6 | |
| Total saturated fatty acids (mg) | 575.9 | 1259.9 | |
| Total monounsaturated fatty acids (mg) | 417.6 | 1323.6 | |
| Total polyunsaturated fatty acids (mg) | 1821.2 | 3151.2 | |
| Polyphenols | Total polyphenols (mgs) | 38.9 | 92.3 |
|
Regular diet: Total cereals = 333 g (Rice: 43 g; 13% + Wheat: 290 g; 87%) Pearl millet diet: Total cereals = 333 g (Pearl millet: 100 g; 30% + Rice: 43 g; 13% + Wheat: 190 g; 57%) | |||
Bold formatting highlights the parameters with greater values in pearl millet
Third phase: After 60 days of intervention with the pearl millet diet, post-test information related to biochemistry, anthropometry and body composition assessment, mental health and meta-cognitive skills was collected following guidelines similar to those used in the pre-test. There were 2 dropouts in the EG and no dropouts in the CG at the end of the study.
Data collection
Anthropometry and Body Composition: The anthropometry and body composition of the participants were determined via the standardised International Society for the Advancement of Kinanthropometry (ISAK) guidelines [33]. The height of the participants was determined by using a stadiometer (Prestige height measuring scale, no. SM-P-W-210 India). Body weight (BW) and composition (body fat and lean body mass) were assessed via a bioelectrical impedance analysis machine (BIA) (TP-Tanita UM076, Singapore).
Estimation of Serum Micronutrients: Venous blood samples (4 mL) from the antecubital vein were taken at pre-test and post-test after an overnight fast of 8–12 h by a trained laboratory technician. The blood sample (3 mL) was taken into with clot activator vial, and after 30–45 min, it was centrifuged at 3000 rpm in a Remi C-852 Clinical Centrifuge machine for 15 min. The serum was collected in eppendorf tubes and stored at − 20 °C for 2 weeks for further analyses. A blood sample (1 mL) in lavender-top (EDTA) vial, which prevents blood from clotting was stored in an ice box during blood sample collection and later stored at − 20 °C for Hb analysis.
Serum ferritin was measured using a Calbiotech Inc (USA) (Catalog No. FR248T), serum folate levels with Calbiotech Inc (USA) (Catalog No. FA370A) and serum vitamin B12 with Calbiotech Inc (USA) (Catalog No. VB369B) ELISA kits. Manufacturer's instructions were adhered for all the kits while preparing the samples for analysis, run in duplicacy and measured at 450 nm absorbance wavelength in Meriley ELISA reader (EQ/Bro/20190624/V1.02/IND, India). Hb was estimated via the cyanmethemoglobin method [34] via a double beam spectrophotometer (LMSOUVI900, India) at wavelength 540 nm.
Mental Health: Sport Mental Health Assessment Tool-1 (SMHAT) questionnaire was used to assess mental health status. This validated tool was developed by the International Olympic Committee (IOC) in 2021 [35]. This test is useful in determining the mental health status of athletes and indicates the presence or risk of developing any mental health problem in them. This tool measures levels of anxiety, depression, sleep disturbance, substance abuse and eating disorders. Step 1 (a score above 16) indicates the potential risk for mental health symptoms and disorders and recommends further screening. The step-2 screening tool (Athletes form-2) is used to assess various mental health problems, such as anxiety, depression, sleep disturbance, alcohol misuse, drug misuse, and disordered eating. A score ≥ 10 indicates the prevalence of anxiety and depression, a score ≥ 8 indicates sleep disturbance, a score ≥ 4 indicates alcohol misuse in men, a score > 3 indicates misuse in women, a score ≥ 2 indicates drug misuse, and a score ≥ 4 indicates disordered eating and eating disorders. If the scores are higher in more than one screening, step 3a is recommended for brief intervention and monitoring. On the basis of the severity of the condition, clinical assessment and management (Step 3b) are recommended. The present study excluded participants with alcohol and drug misuse.
Meta-cognitive skills: The meta-cognitive skills scale (MCSS) developed by Gupta and Suman (2017) is a validated tool designed to measure essential meta-cognitive skills, including planning, monitoring, implementation, and evaluation [3]. This is a five-point Likert-type scale for the assessment of the level of meta-cognitive skills with 42 items under four dimensions, i.e., planning skills (12 items), implementation skills (9 items), monitoring skills (11 items) and evaluation skills (10 items).
Statistical analysis
Statistical analysis was performed via the Statistical Package for Social Sciences (SPSS, version 27.0; IBM, Armonk, NY, USA). The Shapiro–Wilk test was used to determine the normal distribution (p > 0.05) of the data for all the variables. Descriptive statistics are expressed as the means and standard deviation (SD). The significant differences in the measured parameters between the pre-test and post-test were identified via paired t tests, and the differences in the means between the CG and EG were identified via independent t tests. Significance was considered at p < 0.05.
Results
After the pre-test, the participants were randomly distributed to either the EG (n = 28) or the CG (n = 30). The pre-test data showed no significant difference in any parameter, which ensures that the groups are evenly distributed among the two groups and that the observed discrepancies are due to the intervention and not pre-existing inequities (Table 2).
Table 2.
Baseline information mental health and meta cognitive skills and serum micronutrient status of athletes
| Parameter | EG | CG | p-value |
|---|---|---|---|
| Biochemical parameters | |||
| Haemoglobin (g/dL) | 14.6 ± 2.20 | 15.5 ± 2.27 | 0.166 |
| Serum ferritin (ng/mL) | 37.9 ± 28.90 | 39.4 ± 37.51 | 0.858 |
| Serum folate (ng/mL) | 9.8 ± 5.54 | 12.4 ± 5.26 | 0.069 |
| Serum vitamin B12 (pg/mL) | 138.8 ± 73.67 | 201.6 ± 13.64 | 0.088 |
| Mental health | |||
| Form 1—SMHAT | 18.6 ± 5.28 | 16.7 ± 5.38 | 0.187 |
| Anxiety | 4.9 ± 4.09 | 4.7 ± 4.23 | 0.859 |
| Depression | 7.1 ± 5.83 | 6.4 ± 5.36 | 0.648 |
| Sleep disturbance | 6.1 ± 2.91 | 5.9 ± 3.06 | 0.861 |
| Disordered eating | 7.2 ± 3.61 | 6.8 ± 4.55 | 0.728 |
| Meta-cognitive skills | |||
| Planning | 49.0 ± 4.44 | 50.5 ± 2.18 | 0.281 |
| Implementation | 37.2 ± 2.82 | 38.5 ± 4.06 | 0.197 |
| Monitoring | 44.5 ± 4.72 | 46.1 ± 5.63 | 0.194 |
| Evaluation | 40.0 ± 3.92 | 42.1 ± 4.60 | 0.099 |
| Total MCSS | 170.6 ± 13.64 | 177.2 ± 17.2 | 0.132 |
SMHAT: Sports Mental Health Assessment Tool; MCSS: Meta-Cognitive Skills Score; EG: Experimental Group; CG: Control group
Effect of the pearl millet diet on serum micronutrient status
The present study revealed improvements in Hb and serum micronutrient levels in the EG compared with those in the CG after 60 days of the pearl millet diet. The EG group showed increased levels of serum ferritin (37.9 ± 28.90 to 45.3 ± 33.09, p = 0.235) and folate (ng/mL) (9.8 ± 5.54 to 12.2 ± 5.40, p = 0.103), but these changes were not statistically significant. Hb (p = 0.016) and vitamin B12 (pg/mL) (p = 0.052) were significantly increased in the EG, but the mean differences were significant for Hb (p = 0.031) and folate (p = 0.003) (Fig. 2). The CG presented significantly decreased haemoglobin levels (p = 0.034) (Table 3).
Fig. 2.
Mean difference of EG and CG showing effect of pearl millet diet on serum micronutrients status. EG: Experimental Group; CG: Control Group
Table 3.
Effect of Pearl Millet Diet on Serum Micronutrient Status of Athletes
| Biomarker | EG | CG | Mean Difference | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Pre-Test | Post-Test | p-value | Pre-Test | Post-Test | p-value | EG | CG | p-value | |
| Haemoglobin(g/dl) | 14.6 ± 2.20 | 16.82 ± 3.59 | 0.016 | 15.5 ± 2.27 | 14.8 ± 1.77 | 0.034 | 2.2 ± 4.47 | − 0.1 ± 1.66 | 0.003 |
| Serum ferritin (ng/mL) | 37.9 ± 28.90 | 45.3 ± 33.09 | 0.235 | 39.4 ± 37.51 | 38.9 ± 35.60 | 0.918 | 7.4 ± 32.09 | − 0.6 ± 31.43 | 0.344 |
| Serum folate (ng/mL) | 9.8 ± 5.54 | 12.2 ± 5.40 | 0.103 | 12.4 ± 5.26 | 10.2 ± 5.64 | 0.150 | 2.4 ± 7.42 | − 2.3 ± 8.57 | 0.031 |
| Serum vitamin-12 (pg/mL) | 138.8 ± 73.67 | 171.8 ± 78.28 | 0.052 | 201.6 ± 171.54 | 196.1 ± 106.01 | 0.887 | 7.4 ± 32.09 | − 0.7 ± 31.43 | 0.396 |
Bold formatting highlights the significant value in results
Effect of the pearl millet diet on mental health status
The present study showed improvements in mental health in the EG as compared with the CG after 60 days of pearl millet diet. The CG does not show any significant changes in any of the parameters. In the EG, there was a reduction in anxiety (4.9 ± 4.09 to 3.5 ± 3.71, p = 0.148) and depression scores (7.1 ± 5.83 to 5.9 ± 5.19, p = 0.298), although these changes were not statistically significant. However, a significant improvement was observed in disordered eating scores, which decreased from 7.2 ± 3.61 to 5.4 ± 3.58 (p = 0.021). A similar trend was observed in the mean difference between the EG and CG for disordered eating (p = 0.014) (Fig. 3, Table 4).
Fig. 3.
Mean difference of EG and CG showing effect of pearl millet diet on mental health parameters. EG: Experimental Group; CG: Control Group; SMHAT: Sport Mental Health Assessment Tool
Table 4.
Effect of Pearl Millet Diet on Mental Health Status of Athletes
| Parameters | EG | CG | Mean difference | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Pre-Test | Post-Test | p-value | Pre-Test | Post-Test | p-value | EG | CG | p-value | |
| Form1-SMHAT | 18.6 ± 5.28 | 17.5 ± 6.67 | 0.401 | 16.7 ± 5.38 | 16.8 ± 4.92 | 0.186 | − 1.07 ± 6.64 | 0.07 ± 2.72 | 0.405 |
| Anxiety | 4.9 ± 4.09 | 3.5 ± 3.71 | 0.148 | 4.7 ± 4.23 | 5.0 ± 3.65 | 0.894 | − 1.39 ± 4.95 | 0.23 ± 2.79 | 0.134 |
| Depression | 7.1 ± 5.83 | 5.9 ± 5.19 | 0.298 | 6.4 ± 5.36 | 6.3 ± 5.23 | 0.650 | − 1.18 ± 5.87 | − 0.10 ± 2.43 | 0.373 |
| Sleep disturbance | 6.1 ± 2.91 | 6.9 ± 2.87 | 0.216 | 5.9 ± 3.06 | 6.4 ± 3.64 | 0.823 | 0.79 ± 3.45 | 0.43 ± 2.67 | 0.667 |
| Disordered eating | 7.2 ± 3.61 | 5.4 ± 358 | 0.021 | 6.8 ± 4.55 | 7.2 ± 4.25 | 0.382 | − 1.75 ± 3.79 | 0.43 ± 2.60 | 0.014 |
SMHAT: Sports Mental Health Assessment Tool
Bold formatting highlights the significant value in results
Effect of pearl millet diet on meta-cognitive skills
The meta-cognitive skills showed significant improvements in EG. The planning scores increased significantly (p = 0.000), as did the implementation (p = 0.007), monitoring (p = 0.001), evaluation (p < 0.000) and total MCSS (p = 0.002) scores. The CG showed significant changes in planning (p = 0.021), evaluation (p = 0.045) and total MCSS (p = 0.024) scores. The mean difference showed significantly increased scores in the dimensions of the MCSS, i.e., planning (p = 0.046), monitoring (p = 0.041), evaluation (p = 0.024) and total meta-cognitive skills (p = 0.020) in EG (Fig. 4, Table 5).
Fig. 4.
Mean difference of EG and CG showing effect of pearl millet diet on Meta cognitive skill scores. EG: Experimental Group; CG: Control Group; MCSS: Meta Cognitive Skill Scores
Table 5.
Effect of pearl millet diet on meta-cognitive skills of athletes
| Skills | EG | CG | Mean difference | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Pre-Test | Post-Test | p-value | Pre-Test | Post-Test | p-value | EG | CG | p-value | |
| Planning | 49.0 ± 4.44 | 52.4 ± 4.13 | 0.000 | 50.5 ± 2.18 | 51.7 ± 3.72 | 0.021 | 3.18 ± 3.87 | 1.33 ± 3.00 | 0.046 |
| Implementation | 37.2 ± 2.82 | 39.1 ± 3.51 | 0.007 | 38.5 ± 4.06 | 38.9 ± 3.07 | 0.168 | 1.96 ± 3.54 | 0.53 ± 2.06 | 0.069 |
| Monitoring | 44.5 ± 4.725 | 47.3 ± 4.25 | 0.001 | 46.1 ± 5.63 | 47.1 ± 4.55 | 0.107 | 2.89 ± 4.42 | 0.87 ± 2.85 | 0.041 |
| Evaluation | 40.0 ± 3.92 | 43.0 ± 4.73 | 0.000 | 42.1 ± 4.60 | 42.8 ± 3.47 | 0.045 | 3.04 ± 4.26 | 0.90 ± 5.58 | 0.024 |
| Total MCSS | 170.6 ± 13.64 | 181.5 ± 15.01 | 0.002 | 177.2 ± 17.20 | 180.6 ± 12.77 | 0.024 | 10.89 ± 13.72 | 3.63 ± 8.34 | 0.020 |
MCSS: Meta-Cognitive Skills Score
Bold formatting highlights the significant value in results
Discussion
To the best of our knowledge, this is the first study to explore the effects of pearl millet diet serum micronutrient status, mental health and meta-cognitive skills in athletic populations. The pearl millet diet showed a significant change in some of the study outcomes, highlighting the multifaceted and individualised nature of nutritional interventions in the athletic population.
A significant improvement in the serum vitamin B12 and Hb levels and an improvement in the ferritin and folate levels were observed in the EG. Pearl millet does not contain vitamin B12, yet the present study revealed a significant improvement in vitamin B12, which might be due to the high fibre content of pearl millet [21], which helped to improve the gut microbiota [36]. The human gut microbial communities have the capacity to produce vitamin B12 by using both aerobic and anaerobic metabolic pathways at levels fulfilling their own requirements, independent of the initial vitamin B12 content. [37].
The improvement in Hb was directly influenced by the pearl millet diet [21]. Ferritin and folate play crucial roles in haemoglobin levels, and ferritin is the primary iron storage protein, releasing iron as needed for haemoglobin synthesis, which requires iron to form the haeme group in red blood cells. Folate also works in synergy with vitamin B12 in metabolic cycles critical for red blood cell development. Together, ferritin and folate ensure the production of healthy, functional red blood cells, maintaining robust haemoglobin levels and supporting overall oxygen delivery and athletic performance [38, 39]. Furthermore, serum ferritin levels did not significantly change, but it showed a trend of increasing the ferritin level with a pearl millet diet, and it also plays a role in cognitive health, suggesting that longer durations or higher doses might yield more pronounced effects.
The significant improvement in disordered eating and the trends toward reduced anxiety and depression in the EG suggest a potential positive effect of pearl millet diet on mental health. The improvement in disordered eating behaviour is due to the high dietary fibre content of pearl millet [40], which promotes satiety and stabilises blood glucose levels, potentially reducing food cravings and disordered eating tendencies. Dietary fibre which helps in managing the gut micro biota which help in production of metabolites like short-chain fatty acids (SCFAs), in large intestine which reduced the cortisol response and helps in reducing the stress and anxiety levels [41, 42]. Dietary fiber can reduce cortisol levels by promoting the growth of gut microbiota that produce short-chain fatty acids (SCFAs), such as butyrate, which help regulate the gut-brain axis and reduce stress-related inflammation, ultimately lowering cortisol production [43]. Ford et al. reported no significant effects on anxiety, depression or anger after 8 weeks of high vitamin B multivitamin supplementation, although improvements were observed in women with psychological distress [44], these findings support the current study. A review by Muscaritoli suggested that omega-3 fatty acids, magnesium, folic acid, and alpha-tocopherol are among the nutrients that promote mental health by lowering neuro-inflammation, regulating stress reactions, and improving brain function [18]. Pearl millet is a rich source of nutrients such as dietary fibre, iron, fatty acids and phytochemicals [21]. The presence of antioxidants in pearl millet might help in reduce neuronal oxidative stress, which leads to decreased depression [45]. Gautam et al. found that supplementation of antioxidant vitamins shows significant improvement in anxiety and stress [46]. Antioxidants are crucial for brain function, aiding in the regulation of neurotransmitters and reducing inflammation, which shows the positive effect on mood and cognitive performance [47]. Polyphenols, including flavonoids and non-flavonoids, have neuroprotective characteristics that reduce oxidative stress, and promote neurogenesis and neuroplasticity. neurotransmitter function which helps in reducing depression and anxiety [48]. Similarly, B vitamins, particularly B6, B9, and B12, play critical roles in neurotransmitter synthesis, including serotonin and dopamine, which might have helped reduce stress [49]. The study did not find significant changes in sleep scores in either groups. This might be due to other factors related to sleep quality, such as sleep hygiene, practice or late night screen timing.
The pearl millet diet significantly improved meta-cognitive skill scores, such as planning, implementation, monitoring, evaluation and total MCSS scores, in the EG, which are critical for athletic decision-making, strategic planning, and adaptability during competition. The pearl millet diet might be responsible for these observed improvements [27, 50], as evidenced by the improved serum micronutrient status in the EG. 6-month pearl millet supplementation improved cognitive function in school-aged adolescent children [51]. Iron deficiency has been linked to fatigue, irritability, and headache and palpitation, anxiety, restless and low mood [52].
Pearl millet contains a diverse fatty acid profile, including palmitic, stearic, arachidic, oleic, palmitoleic, and linolenic acids, along with total saturated fatty acids (TSFA), total monounsaturated fatty acids (TMSA), and total polyunsaturated fatty acids (TPFA). These fatty acids play a crucial role in neurotransmitter synthesis, brain cell membrane integrity, and neuroinflammation regulation, all of which reduce the anxiety, stress and depression and help in improving the cognition [53].
This rich profile of omega fatty acids, polyunsaturated fatty acids (PUFAs), and antioxidant vitamins (alpha-tocopherol, gamma-tocopherol, vitamin A) is responsible for better cognitive skills in athletes. Similar results were also reported by Stavrinou et al. (2020), who reported that 6 months of supplementation with a cocktail composed of omega fatty acids and vitamins improved cognitive function in older individuals [54]. The significant improvement in planning, evaluation and total MCSS in CG suggests that factors unrelated to diet, such as on-going academic or training activities, might also affect meta-cognitive skills [19]. Significant mean differences were observed across all metacognitive skills, which suggests a distinct advantage in the EG, possibly related to the micronutrient content of pearl millet.
Conclusion
This study highlights the significant positive impacts of pearl millet diet on serum micronutrient status, mental health, and metacognitive skills in athletes. These results demonstrate that a regular pearl millet diet improves increased serum levels of critical micronutrients such as folate, vitamin B12, ferritin, and haemoglobin suggest improved nutritional status, which is essential for overall health and athletic performance. Notable improvements in mental health indicators, including reduced risk for disordered eating, anxiety and depression, and enhanced meta-cognitive skills, can be attained with a pearl millet diet. Incorporate pearl millet in athlete’s regular diet could be the practically cost effective strategy to enhance both physical and mental well-being.
Limitations
The study used 1/3 of pearl millet in lieu of regular cereals. The intervention time period of 60 days may not help in providing significant results in terms of these parameters. The CG followed the regular diet, whereas the pearl millet recipes were provided to the EG, which might introduce bias in the study results. The study data rely on specific tools such as the SMHAT-1 and MCSS questionnaires for mental health and meta-cognitive skills. Tests of the gut microbiota like 16S rRNA which identify and compare the bacterial diversity can help to ensure that the increase in the serum vitamin B12 concentration in the EG is due to the improved gut health of athletes.
Acknowledgements
We thank all the study participants, Mr. Sarkar Talwar (Director of Sport at Manav Rachna University) for allow us to conduct study, Mr. Vijay (Food Science Lab technician at SAHS, MRIIRS) for helping us in food preparation, Mr. Satish (Biotechnician at MRDC) for taking blood samples, Dr Shakila Mahesh (Prof. Microbiology at MRIIRS) for allowing us to use microbiology lab and Mr Sukhbeer (Microbiology Lab Technician) for help us in using ELISA machine.
Abbreviations
- EG
Experimental Group
- CG
Control Group
- Hb
Haemoglobin
- SMHAT-1
Sport Mental Health Assessment Tool-1
- MCSS
Meta cognitive skill score
- PL-3
Physical Performance Level 3
- ISAK
International Society for the Advancement of Kinanthropometry
- BW
Body weight
- BIA
Body impedance analysis
- ELISA
Enzyme-Linked Immunosorbent Assay
Author contributions
Funds Acquisition: BDR, KK, GLK; Conceptualisation: KK, GLK; Permissions, Ethics approval: KK, GLK; Providing and monitoring of pearl millet Diet for 60 days: AS, ET; Data Collection: AS, ET; Supervision of Data Collection: KK, GR; Data Entry: AS; Data Analysis and Interpretation: KK, AS, GLK, GR; Drafting of manuscript: AS; Review and Finalisation of Manuscript: KK, GLK, BDR, GR, ET. All the authors approved the final version of the manuscript to be published.
Funding
This work was supported by Manav Rachna International Institute of Research & Studies, funded by National Food Security Mission (NFSM), Indian Council of Agricultural Research (ICAR), Ministry of Agriculture and Farmers Welfare (MOAFM), Government of India (F.No.18-3/2022-NFSM (FTS-111308E)) under a project “A Comprehensive Study to Establish the in –vivo health benefits of Nutri-Cereals: A way forward for mainstreaming millets”.
Data availability
To protect the privacy of the participants, the datasets generated and/or analyzed during the current study are not publicly accessible. However, they are available from the corresponding author upon reasonable request.
Declarations
Ethics approval and consent to participate
The trial received ethics approval from the Manav Rachna International Institute of Research & Studies, ethical committee approvel no.- EC/2023-24/036. The study was also done clinical trial registration No. CTRI/2023/10/059332. All procedures were conducted in accordance with the ethical standards of the Declaration of Helsinki.
Consent for publication
Informed consent was obtained from all individual participants included in the study. Participation was voluntary, and participants were informed about the purpose of the study, the procedures involved, their right to withdraw at any time, and data confidentiality.
Competing interests
The authors declare no competing interests.
Footnotes
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
To protect the privacy of the participants, the datasets generated and/or analyzed during the current study are not publicly accessible. However, they are available from the corresponding author upon reasonable request.