From rhythm to resilience: The interplay of circadian rhythm, melatonin, lifestyle, nutrition in psychoneuroimmunology (PNI)
Chang Jane Pei-Chen, Su Kuan-Pin

TL;DR
This paper explores how circadian rhythms, melatonin, lifestyle, and nutrition influence mental and physical health through interconnected biological systems.
Contribution
It introduces a multidimensional model linking circadian biology, nutrition, and inflammation for personalized psychiatry and preventive care.
Findings
Circadian disruptions are linked to neuroinflammation and mood disorders like ADHD and MDD.
Omega-3 fatty acids and paeoniflorin show therapeutic potential in mental and cardiovascular health.
Lifestyle interventions like Tai Chi support non-pharmacological approaches to mental resilience.
Abstract
Emerging evidence reveals that circadian rhythm, melatonin signaling, nutrition, and inflammation are intricately intertwined in shaping both mental and physical health. Circadian disruptions and lifestyle imbalances contribute to neuroinflammation, mood dysregulation, and cardiometabolic dysfunction, as seen in attention-deficit/hyperactivity disorder (ADHD), major depressive disorder (MDD), metabolic syndrome, and cardiovascular diseases. This special issue highlights interdisciplinary research that integrates circadian biology, nutrition, and psychoneuroimmunology (PNI) toward personalized and preventive psychiatry. Featured studies explore circadian and melatonin mechanisms in ADHD and MDD, the therapeutic and prophylactic potential of omega-3 polyunsaturated fatty acids (n-3 PUFAs), the neuroprotective potentical of paeoniflorin, and the role of extracellular matrix gene variants…
Genes, proteins, chemicals, diseases, species, mutations and cell lines named across the full text — each resolved to its canonical identifier and authoritative record.
- —MOST
- —National Science and Technology Council (NSTC), Taiwan
- —An-Nan Hospital, China Medical University (CMU), Tainan, Taiwan
- —Higher Education Sprout Project by the Ministry of Education (MOE), Taiwan
- —CMU, Taichung, Taiwan
- —CMU Hospital, Taichung, Taiwan
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Taxonomy
TopicsTryptophan and brain disorders · Circadian rhythm and melatonin · Sleep and related disorders
Introduction
The interplay among circadian rhythms, nutrition, and lifestyle provides new perspectives for addressing common mental and physical disorders. The body's internal clock orchestrates circadian rhythms, playing a crucial role in regulating immune function and neurochemical homeostasis [1]. Disruptions in these rhythms have been implicated in the development of various neuropsychiatric conditions, such as attention-deficit hyperactivity disorder (ADHD) [2] and major depressive disorder (MDD) [3], as well as in cardiovascular diseases [4]. Furthermore, growing evidence highlights inflammation as a shared underlying mechanism among these disorders. Elevated inflammatory markers have been observed in ADHD [5], MDD [6], and cardiovascular diseases, particularly when comorbid with MDD [7]. In contrast, healthy nutritional habits and lifestyle interventions—such as regular physical activity and improved sleep hygiene—have shown promise in reducing neuroinflammation, restoring circadian balance, and promoting both mental and cardiovascular health [8].
Off the beat with circadian rhythm and singing the blues with a broken heart
Disruptions in circadian rhythms and melatonin secretion have been closely linked with a range of neuropsychiatric disorders—including ADHD [2,9], Alzheimer's disease [10], anxiety and depression [3,11], bipolar disorder [12], suicide attempts [13], as well as physical conditions such as coronary artery disease [4], irritable bowel syndrome [14], migraine [10], and pain [15]. Inflammation appears to be the critical link connecting circadian and melatonin dysregulation to these disorders. For instance, elevated inflammatory biomarkers, including interleukin-6 (IL-6) and C-reactive protein (CRP), are observed in ADHD [5] and MDD [6,16]. Genetic polymorphisms in proinflammatory genes, such as IL-6 (−174G > C) and TNF-α (−308G > A), have also been associated with heightened susceptibility to acute coronary syndromes [17]. On the other hand, melatonin exhibits notable anti-inflammatory properties through its capacity to scavenge reactive oxygen species and mitigate oxidative damage across multiple organ systems [1]. It further inhibits the nuclear translocation of nuclear factor-kappa B (NF-κB) and its subsequent DNA binding, thereby downregulating proinflammatory cytokines such as interleukins and tumor necrosis factor-alpha [1].
Fine tuning with nutrition, melatonin, and behavioral intervention
Emerging research in Lifestyle Medicine underscores the therapeutic potential of nutritional supplementation and physical activity in mitigating symptoms of ADHD, MDD, and cardiovascular disease. Nutritional interventions, particularly omega-3 polyunsaturated fatty acids (n-3 PUFAs), have demonstrated beneficial effects in alleviating clinical symptoms of ADHD [18] and MDD [19–21]. Iqbal et al. suggested that n-3 PUFAs may exert these effects by counteracting melatonin and circadian dysregulation in ADHD [2], while Malau et al. highlighted their prophylactic role in MDD [22]. Zailani et al. further explored the genetic variations in extracellular matrix degradation pathways that may contribute to MDD pathophysiology [23]. Additional compounds, such as paeoniflorin, have also been proposed to possess antidepressant potential [24]. Le et al. reinforced the role of melatonin in neuropsychiatric disorders through evidence spanning preclinical and clinical studies [25]. Beyond nutrition, physical activity is pivotal. Cheng et al. demonstrated that Tai Chi enhances cardiovascular fitness, lowers blood pressure, improves vascular function, and simultaneously reduces psychological stress while fostering emotional balance [26].
Personalized treatment with multidisciplinary approach and keeping rhythm
In an era of chronic stress and digital stimulation, maintaining internal balance is vital. Lifestyle Medicine—including circadian alignment, targeted nutrition, and regular movement—must be emphasized as a preventive strategy. Advancements in molecular research pave the way for genetically based personalized interventions. Ultimately, harmonizing the ‘inner orchestra’ is the holistic strategy required to mitigate inflammation and reduce the global burden of mind–body disorders [8].
The reference list from the paper itself. Each links out to its DOI / PubMed record.
- 1Reiter RJ Calvo JR Karbownik M Qi W Tan DX Melatonin and its relation to the immune system and inflammation Ann N Y Acad Sci 2000 917 376 86 10.1111/j.1749-6632.2000.tb 05402.x 11268363 · doi ↗ · pubmed ↗
- 2Iqbal AZ Suwindi PM Chen SYS Cho LLT Su KP Chang JPC Circadian rhythms and neuroendocrine dysregulation in ADHD: therapeutic insights from omega-3 fatty acids Biomedicine (Taipei) 2025 In press
- 3Satyanarayanan SK Su H Lin YW Su KP Circadian rhythm and melatonin in the treatment of depression Curr Pharm Des 2018 24 2549 55 10.2174/1381612824666180803112304 30073921 · doi ↗ · pubmed ↗
- 4Sakotnik A Liebmann PM Stoschitzky K Lercher P Schauenstein K Klein E Decreased melatonin synthesis in patients with coronary artery disease Eur Heart J 1999 20 1314 7 10.1053/euhj.1999.1527 10462465 · doi ↗ · pubmed ↗
- 5Chang JP Mondelli V Satyanarayanan SK Chiang YJ Chen HT Su KP Cortisol, inflammatory biomarkers and neurotrophins in children and adolescents with attention deficit hyperactivity disorder (ADHD) in Taiwan Brain Behav Immun 2020 88 105 13 10.1016/j.bbi.2020.05.017 32418647 · doi ↗ · pubmed ↗
- 6Chang JP Lin CY Lin PY Shih YH Chiu TH Ho M Polyunsaturated fatty acids and inflammatory markers in major depressive episodes during pregnancy Prog Neuropsychopharmacol Biol Psychiatry 2018 80 Pt C 273 8 10.1016/j.pnpbp.2017.05.008 28536068 · doi ↗ · pubmed ↗
- 7Chang JP Chang SS Yang HT Palani M Chen CP Su KP Polyunsaturated fatty acids (PUF As) levels in patients with cardiovascular diseases (CV Ds) with and without depression Brain Behav Immun 2015 44 28 31 10.1016/j.bbi.2014.11.005 25452150 · doi ↗ · pubmed ↗
- 8Su KP Harmonizing the inner orchestra: the impact of urbanization and evolution of stress, inflammation, diet, and lifestyles in depression Curr Opin Psychiatry 2025 38 209 16 10.1097/YCO.0000000000000986 39804221 · doi ↗ · pubmed ↗
