This podcast episode is based on Journey to Recovery: A Comprehensive Guide to Recovery from Mental Health and Addiction Issues by Dr. Dawn-Elise Snipes Read it for free on Amazon Kindle Unlimited.
Journey to Recovery Series
Complimentary Interventions
Nutrition
Presented by: Dr. Dawn-Elise Snipes Executive Director, AllCEUs
CEUs are available at https://allceus.com/member/cart/index/product/id/924/c/
Objectives
~ Review the nutritional building blocks for health and wellness
~ Examine how these nutrients (or lack thereof) contribute to neurotransmitter balance
~ Identify several nutrient dense foods that you can include in your diet
~ Note: Nutritional changes should always be made under the supervision of a registered dietician or your primary physician. This presentation is for general informational purposes only.
Why I Care/How It Impacts Recovery
~ In early recovery, nearly every person’s neurotransmitters are out of balance.
~ This causes feelings of depression, apathy, anxiety, and/or exhaustion.
~ Understanding why you feel the way you do is the first step
~ Figuring out how to help yourself feel better is the next
What are Neurotransmitters
~ The human brain is composed of roughly 86 billion neurons.
~ These cells communicate with each other via chemical messengers called neurotransmitters.
~ Neurotransmitters regulate
~ Mood
~ Cravings, addictions
~ Energy
~ Libido
~ Sleep
~ Attention and concentration
~ Memory
~ Pain Sensitivity
Neurotransmitters Cont…
~ About 86% of Americans have suboptimal neurotransmitter levels — our unhealthy modern lifestyle being largely to blame.
~ Chronic stress, poor diet, environmental toxins, drugs (prescription and recreational), alcohol, nicotine, and caffeine can cause neurotransmitter imbalances.
Think about it
~ How do you feel when you are not getting enough oxygen? (Hint: You yawn)
~ What effect might a low carb diet have on mood?
~ What effect might a low protein diet have on mood? (Most non-vegan Americans get plenty of protein)
~ Why do doctors test for vitamin-D levels in patients with depressive symptoms?
Amino Acids (Protein Building Blocks)
Essential Amino Acids
~ Must be acquired from diet:
~ Valine
~ Isoleucine
~ Leucine
~ Lysine
~ Methionine
~ Phenylalanine
~ Threonine
~ Tryptophan
Complete vs. Incomplete Proteins
~ Complete proteins are those that contain all essential amino acids:
~ Meat
~ Fish
~ Dairy products (milk, yogurt, whey)
~ Eggs
~ Quinoa*
~ Buckwheat*
~ Chia seed*
~ Spirulina*
Complete vs. Incomplete Proteins
~ Incomplete proteins are those that don’t contain all 9 essential aminos
~ Nuts & seeds
~ Legumes
~ Grains
~ Vegetables
Amino Acids (Proteins)
~ Protein Digestibility-Corrected Amino Acid Score, PDCAAS
Tryptophan
~ Food Sources: Egg whites, chia seeds, sesame seeds, wheat germ, turkey
~ Needs Iron, magnesium, B6 and Vitamin C to convert tryptophan to serotonin
~ More readily absorbed when eaten with high carbohydrate meal.
~ Insulin causes competing amino acids to be absorbed into the tissues
~ Only precursor to serotonin
~ Focus on Tryptophan by John W. Crayton, MD, Professor of Psychiatry at Loyola University Medical School, Maywood, Illinois. NOHA* NEWS, Winter 2001
~ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908021/ L-Tryptophan: Basic Metabolic Functions, Behavioral Research and Therapeutic Indications Int J Tryptophan Res. 2009; 2: 45–60.
Important Non-Essential Amino Acids
~ Arginine helps with insomnia
~ Glutamine GlutamateGABA
~ Theanine: Increases GABA and serotonin levels (Green Tea)
~ Tyrosine: Used to make dopamine and norepinepherine and thyroid hormones.
~ Parmesan, mozzarella, swiss cheeses, lean beef, pork or salmon, tuna or mackerel, chicken breast, pumpkin seeds, peanuts, sunflower seeds, dairy, beans
B Vitamins
~ Low levels of B vitamins may be linked to depression.
~ Vitamin B3 (Niacin)
~ Food sources: Poultry, fish, meat, whole grains, and fortified cereals
~ What it does:
~ Helps with digestion and changing food into energy
~ Helps body conserve tryptophan and convert it into serotonin
B Vitamins
~ Vitamin B 5 Pantothenic Acid
~ Food sources include: beef, mushrooms, eggs, vegetables, legumes, nuts, pork, saltwater fish, whole rye flour, whole wheat
~ What it does
~ Help control the secretion of cortisol
~ Help with migraines and chronic fatigue syndrome
~ Supplementation in very high doses can increase in panic attacks
B Vitamins
~ Vitamin B6
~ Food sources include: Fortified cereals, fortified soy-based meat substitutes, baked potatoes with skin, bananas, light-meat poultry, eggs, peas, spinach
~ What it does: Supports your nervous system by helping the body break down proteins.
~ Vitamin B9- Folate
~ What it does: May reduce depression when taken in conjunction with vitamin B12.
~ Food sources include: Spinach, kale, lentils, asparagus, black eyed peas, broccoli, avocado, French bread
B Vitamins
~ Vitamin B12
~ Food sources include: Beef, eggs, shellfish, salmon, poultry, soybeans, yogurt, tuna and fortified foods
~ What it does:
~ Helps with cell division and helps make red blood cells.
~ Deficiency can lead to mood problems, including depression, anxiety, poor memory, difficulty concentrating
http://www.mayoclinic.org/diseases-conditions/depression/expert-answers/vitamin-b12-and-depression/faq-20058077
http://www.calmclinic.com/blog/calm-clinic-review-b-vitamins
Fava M, Borus JS, Alpert JE, Nierenberg AA, Rosenbaum JF, Bottiglieri T. Folate, vitamin B12, and homocysteine in major depressive disorder. Am J Psychiatry. 1997;154:426-428.
Alpert JE, Mischoulon D, Nierenberg AA, Fava M. Nutrition and depression: focus on folate. Nutrition. 2000;16:544-546
Vitamin C
~ Food sources include: Citrus, berries, tomatoes, potatoes, broccoli, cauliflower, brussels sprouts, bell peppers, cabbage, spinach
~ What it does:
~ Promotes a healthy immune system
~ Helps make collagen.
~ It's also needed to regulate norepinepherine, dopamine and serotonin
~ Associated with significant reductions in anxiety.
Pak J Biol Sci. 2015 Jan;18(1):11-8. Effects of Oral Vitamin C Supplementation on Anxiety in Students: A Double-Blind, Randomized, Placebo-Controlled Trial
Wang Y, Liu XJ, Robitaille L, Eintracht S, MacNamara E, Hoffer LJ. Effects of vitamin C and vitamin D administration on mood and distress in acutely hospitalized patients. Am J Clin Nutr. 2013 Sep;98(3):705-11.
Mazloom Z, Ekramzadeh M, Hejazi N. Efficacy of supplementary vitamins C and E on anxiety, depression and stress in type 2 diabetic patients: a randomized, single-blind, placebo-controlled trial. Pak J Biol Sci. 2013 Nov 15;16(22):1597-600.
http://www.livestrong.com/article/525632-link-between-vitamin-c-deficiency-anxiety/
J Neurochem. 2013 Feb;124(3):363-75. Behavioral and monoamine changes following severe vitamin C deficiency.
Vitamin D-3 (Sunlight Vitamin)
~ Food sources include: Fortified milk, cheese, and cereals; egg yolks; salmon, cod liver oil
~ What it does:
~ Maintains bone health and helps the body process calcium;
~ Important for immune system function
~ Related to a reduction in depression as it affects the amount of chemicals called monoamines, such as serotonin, and how they work in the brain
J Intern Med. 2008 Dec;264(6):599-609. Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomized double blind trial.
J Chem Neuroanat. 2005 Jan;29(1):21-30. Distribution of the vitamin D receptor and 1 alpha-hydroxylase in human brain.
Am J Geriatric Psychiatry 2006Dec; 14(12): 1032-1040 Vitamin D Deficiency Is Associated With Low Mood and Worse Cognitive Performance in Older Adults
Calcium
~ Food sources include: Dairy products, broccoli, dark leafy greens, and fortified dairy, grains and juices
~ What it does:
~ Helps build and maintain strong bones and teeth.
~ Helps muscles work.
~ Supports cell communication.
~ Deficiency causes nerve sensitivity, palpitations, irritability, anxiety, depression and insomnia
~ Excess can cause depression and difficulty concentrating
A Beneficial Effect of Calcium Intake on Mood Kamyar Arasteh, Ph.D. Journal of Orthomolecular Medicine
Chromium
~ Food sources include: Some cereals, beef, turkey, fish, broccoli, and grape juice
~ What it does:
~ Helps maintain normal blood sugar (glucose) levels
~ Influences the release of norepinepherine and serotonin
~ Researchers at Duke University have found that a daily dose of 600 mcg of chromium led to a significant decrease in symptoms among those with atypical depression especially their tendency to overeat
Davidson JR, Abraham K, Connor KM, McLeod MN. Effectiveness of chromium in atypical depression: a placebo-controlled trial. Biol Psychiatry. 2003;53:261-264. Abstract
Copper
~ Food sources include: Seafood, cashews, sunflower seeds, wheat bran cereals, whole-grain products, avocados, and cocoa products
~ What it does:
~ Helps break down iron
~ Make red blood cells
~ Helps produce energy for cells
~ Helps maintain bones, connective tissue, and blood vessels.
~ High copper and low zinc can contribute to depression
Indian J Physiol Pharmacol. 1991 Oct;35(4):272-4. Levels of copper and zinc in depression.
Iodine
~ Food sources include: Iodized salt, some seafood, kelp, and seaweed
~ What it does: Works to make thyroid hormones.
~ Deficiency: Weight gain, fatigue, difficulty concentrating, depression
Philip NS, et al. “Pharmacologic Approaches to Treatment Resistant Depression: A Re-examination for the Modern Era,” Expert Opinions in Pharmacotherapy (April 2010): Vol. 11, No. 5, pp. 709–22
Iron
~ Food sources include: Leafy green vegetables, beans, shellfish, red meat, eggs, poultry, soy foods, and some fortified foods
~ What it does: Carries oxygen to all parts of the body through red blood cells, synthesis of neurotransmitters. (Helps fight fatigue and brain fog)
~ Indian J Psychiatry. 2008 Apr-Jun; 50(2): 77–82. Understanding nutrition, depression and mental illnesses
Magnesium
~ Food sources include: Whole grains, leafy green vegetables, almonds, Brazil nuts, soybeans, halibut, peanuts, hazelnuts, lima beans, black-eyed peas, avocados, bananas, cocoa
~ What it does:
~ Helps muscles and nerves work
~ Optimizes thyroid function
~ Steadies heart rhythm
~ Maintains bone strength
~ Helps the body create energy
http://kellybroganmd.com/magnesium-most-important-female-supplement/
Pharmacol Rep. 2013;65(3):547-54. Magnesium in depression.
Rapid recovery from major depression using magnesium treatment Eby, George A. et al. Medical Hypotheses , Volume 67 , Issue 2 , 362 – 370
Omega 3 Fatty Acids
~ Food sources include: Walnuts 1/3c., chia seeds 4t., 2/3 cup mackerel, 9 ounces tuna, 1 T salmon fish oil
~ Use canola, olive and flaxseed oil to increase omega-3s
~ Flax Seeds are not nearly as efficient at producing positive effects because the ALA needs to be converted to EPA and DHA to be useful
~ What it does:
~ Helps your body transmit nerve signals
~ Maintain serotonin balance
~ Reduce inflammation
Omega 3s and Omega 6s
~ “The ideal ratio is one to one or two to one, omega-6 to omega-3.”
~ The American diet has been flooded with omega-6 fatty acids, mostly in the form of vegetable oils such as corn oil and safflower oil.”
Artemis Simopolous, MD, who directs the Center for Genetics, Nutrition and Health, in Washington, D.C http://www.webmd.com/diet/healthy-kitchen-11/omega-fatty-acids?page=3
J Clin Psychiatry. 2009 Dec; 70(12): 1636–1644. A Double-Blind Randomized Controlled Trial of Ethyl-Eicosapentaenoate (EPA-E) for Major Depressive Disorder
Nemets B, Stahl Z, Belmaker RH. Addition of omega-3 fatty acid to maintenance medication treatment for recurrent unipolar depressive disorder. Am J Psychiatry. 2002;159:477-479.
Cott JM. Omega-3 essential acids and psychiatric disorders. Program and abstracts of the American Psychiatric Association 2004 Annual Meeting; May 1-6, 2004; New York, NY. Symposium 19B.
http://www.health.harvard.edu/staying-healthy/why-not-flaxseed-oil
http://www.doctoroz.com/article/daily-dose-omega-3
Lycopene
~ What it does: Antioxidant, prevents brain degradation with age
~ Food sources include (Reds): Watermelons, pink grapefruits, apricots, tomatoes (cooked is better)
~ J Affect Disord. 2013 Jan 10;144(1-2):165-70. A tomato-rich diet is related to depressive symptoms among an elderly population aged 70 years and over: a population-based, cross-sectional analysis.
~ https://draxe.com/lycopene/
Potassium
~ Food sources include: Broccoli, potatoes with the skin, prune juice, orange juice, leafy green vegetables, bananas, raisins, and tomatoes
~ What it does: Required to activate neurons; helps maintain a healthy balance of water
~ “Without the electrical charge sparked by potassium, neurotransmitters like serotonin cannot be utilized to make us feel better.”
~ Br J Nutr. 2008 Nov;100(5):1038-45. doi: 10.1017/S0007114508959201. Epub 2008 May 9. Dietary electrolytes are related to mood.
~ Nat Neurosci. 2006 Sep;9(9):1134-41. Epub 2006 Aug 13. Deletion of the background potassium channel TREK-1 results in a depression-resistant phenotype.
~ McCleane, G. J. and Watters, C. H. (1990), Pre-operative anxiety and serum potassium. Anaesthesia, 45: 583–585.
Selenium
~ Food sources include: Brazil nuts, Brown rice, turkey, Chicken, Spinach, sunflower seeds
~ What it does:
~ Antioxidant
~ Regulates thyroid hormone
~ Helps regulate circadian rhythm
~ Caution toxicity is easy. Upper limits are only 55-60mcg for adult females
~ The Importance of Selenium to Human Health. Margaret P. Rayman Centre for Nutrition and Food Safety, School of Biological Sciences, University of Surrey, Guildford GU2 5XH
Zinc
~ Food sources include: Red meat, fortified cereals, oysters, almonds, peanuts, chickpeas, soy foods, and dairy products
~ What it does:
~ Supports immune, reproductive and nervous systems,
~ Balances with copper.
~ Deficiency: Anxiety
~ The Neuropsychotherapist. Kim Uildriks (2016); 4(12): 16-17. Clinical Implications of Zinc Deficiency for Anxiety.
Effect of Nutrition on Brain Function
~ Eating foods with a low glycemic index improves the quality and duration of intellectual performance http://www.glycemicindex.com/
~ Dietary proteins contribute to good brain function
~ Tryptophan is necessary for the creation of serotonin and melatonin
~ Brain cell functioning requires omega-3 fatty acids.
~ Omega-3s have also been found to help prevent and/or treat mood disorders, particularly depression
~ Iron is necessary to ensure oxygenation and for the synthesis of neurotransmitters.
Effect of Nutrition on Brain Function
~ The iodine is necessary for energy metabolism in the brain cells.
~ Vitamin B1 is necessary for the utilization of glucose in the brain.
~ Vitamins B6 and B12, among others, are directly involved in the creation of neurotransmitters.
~ Nerve endings contain the highest concentrations of vitamin C in the human body.
~ Vitamin E is necessary for effective transmission of neurological signals
Helpful Notes
~ When you get nutrients from real foods
~ There is much less danger of toxicity
~ It is more bioavailable in most instances because it is in a useful ratio
~ Nature is all about balance—increases in one may decrease others
~ Buy/grow organic fruits and vegetables to maximize nutrient value
~ Download an app such as Spark People or MyFitnessPal to track your nutrition.
~ Small changes are longer lasting. Try to add more of one type of food that has multiple vitamins.
Summary
~ Deficiencies of nutrients such as calcium, magnesium, zinc, omega-3 fatty acids, and vitamins A, B-complex, C, D3 and E are common, especially if you eat refined foods.
~ There are a variety of different vitamins and minerals involved in addiction and mental health disorders
~ It is not always about increasing a vitamin or mineral. Sometimes you need to decrease it.
~ Human brains try to maintain homeostasis and too much or too little can be bad
~ A balanced diet will provide the brain the necessary nutrients in synergystic combinations
Nutrient Summary
Other Resources
~ An overlooked connection: serotonergic mediation of estrogen-related physiology and pathology Leszek A RybaczykEmail author, Meredith J Bashaw, Dorothy R Pathak, Scott M Moody, Roger M Gilders and Donald L Holzschu. BMC Women's Health BMC series open, inclusive and trusted 2005 5:12
~ Isr Med Assoc J. 2003 Sep;5(9):653-8. Aggression: the testosterone-serotonin link. Birger M1, Swartz M, Cohen D, Alesh Y, Grishpan C, Kotelr M.
~ Phytother Res. 2011 Nov;25(11):1636-9.
~ Nutr Neurosci. 2013 Jul 23.