Nutrition and mental health

Nutrition and Mental Health

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

Ric Saguil, MDBikram Yoga Naperville

May 2011

My Doctor: Listens to my concerns Cares what I have to say Doesn’t Keep Me Waiting Gives Me Options

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

First Health Associates

2010 S. Arlington Heights RdLL Suites

Arlington Heights, IL

The First Health Approach

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

Your Community of Care

Ric Saguil, MDJason Gruss, MDTom Jordan, RD

Katrina Christie, LCPCJennifer Green, NDJoe Musolino, DCAmy Iaquinta, DCNick Nowicki, DC

Emery Paredes, PTCourtney Day, EPYu Zhu, MD China

Mike Blumberg, LCPC

You

Physiology 101

Jill Bolte Taylor

You’ve got nerve!

The extension cords

Where the music happensThe Synapse

How medicines help

Drug Classes

• SSRI Lexapro, Prozac, Zoloft, Paxil, Effexor

•MAOI Marplan, Parnate, Nardil

• Tricyclics Pamelor, Norpramin, Tofranil, Amytriptyline

• Atypical Abilify, Risperidal, Geodon, Zyprexa, Seroquel

• Other Classes Wellbutrin, Lamictal, Depakote

Top 5 classes of drugs purchased ‘08

• Cardiovscular• Central Nervous System• Metabolic Agent• Hormones/Hormone Modifiers• Psychotherapeutic Agents 206,294,564 purchases, 27,953,909 buyers Medical Expenditure Panel Survey US Dept Health and Human Svs

Top 5 Psych Drugs 2009

• Xanax 44,029,000 A• Lexapro 27,698,000 A/D• Ativan 25,868,000 A• Zoloft 19,500,000 D• Prozac 19,499,000 D/A

• Desyrel 18,873,000 D/A• Cymbalta 16,626,000 D/A• Seroquel 15,814,000 D/A

“My Bad”

Congrats!

You now know the standard medicine approach!

The Saguil Approach• History (more than 7 minutes)• Search for other causes Thyroid Adrenal Nutritional Deficiency Metal Toxicity Food Allergy Abuse(teen) Rheumatologic (autoimmune) FMS (CRPS) Coexisting Mental Disorder LD/ADD PMS Drug Side Effects

• Behavioral Therapy Positive Psychology , CBT, EMDR(Imvmtdesensreprossg) • Herbal/Homeopathic• Medical Acupuncture• Nutritional Medicine

Integrative

Wellness TeamRic Saguil, MD

Jason Gruss, MDTom Jordan, RD

Katrina Christie, LCPCJennifer Green, NDJoe Musolino, DCAmy Iaquinta, DCNick Nowicki, DC

Emery Paredes, PTCourtney Day, EPYu Zhu, MD China

Mike Blumberg, LCPC

You

Food and mood

• Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) Study

1,118 30-64 y/o Baltimore MD 24hr diet recall= diet quality significantly associated with symptoms of depression

• Dietary pattern and depressive symptoms in middle age

3486 participants participants in the highest tertile of the whole food pattern had

lower odds of CES–D depression /high consumption of processed food was associated

with an increased odds of CES–D depression

Whole Foods Healing (from Healing with Whole Foods)

• Oyster shell (ca++)• Grain (whole wheat, brown rice, oats)• Mushrooms (chinese as an immune tonic)• Silicon foods (barley gruel, cucumber, celery, lettuce,

celery/lettuce juice all to improve calcium metab)• Fruit (lemons, schisandra berries-wu wei zi)• Seeds (jujube seeds-suan zoa ren, chia)• Spices (dill, basil)• Herbs (chamomile, catnip, scullcap, valerian)• Animal Products (quality cow and goat milk, clarified butter-

ghee)

Why “whole foods”

Why not processed?

Glycemic Index Theory and Processed Foods

Work it sugar!

slow

Fast

Fast spikes in blood glucose =

Fast drop in blood glucose

The First Health Performance Diet

• High Powered Oat Breakfast (Oatmeal, Flaxseed, Walnuts, Apples, Cinnamon)

• Greek Yogurt (140 cal, 14g protein)

• PVC Lunch: Turkey Sandwich, Vegetable Soup

• Afternoon Go-To: – Cottage Cheese + Fruit– Almonds + Cheese Stick– Paleoshake (protein, almond milk, frozen fruit)

• PVC Dinner: 4oz Salmon, 1c Broccoli, Sweet Potatoes, 2 cups Spinach salad w/ Balsamic

Tom Jordan, RD

Whole Foods

• Non Processed Foods• Healthy fats (O3) • Fruits and Vegetables (7-10?)• Legumes• Grain (fiber)• Tea(green)• Fish/chicken (for beef/pork)

Omega 3

• Fish Consumption and Depressive Symptoms in the General Population in Finland 3204 sampled

results showed a relatively powerful and independent association between fish consumption and decreased depressive symptoms in this population sample of 3,402 Finnish adults

• Omega-3 Treatment of Childhood Depression: A Controlled, Double-Blind Pilot Study

Omega 3 fatty acids may have therapeutic benefits in childhood depression

Fatty Facts:

• ALA short chain fatty acids

• EPA DHA long chain fatty acids

• Conversion from ALA to E and D depends on how much omega 6 is in diet• Proper ration omega 6/omega 3 = 1:1 1:4 US diet 10:1 20:1• 3 gm EPA/DHA daily safe• Alcohol, US diet, Stress (amphetamine/dopamine

depleation)

Organic when you can

“Low and slow” exposure to allergen

Detox Diet

Elimination Diet

Piggy back products in/on your food

• Bacteria • Pesticides• Mercury• Antibiotics• Hormones • Genetic contaminants (GMO)• It may not be your allergic, could be your toxic

Go broke with Organics? Pay up now or pay up later

US soil not as good as before

• The Metabolic Tune-Up: Metabolic Harmony and Disease Prevention

25% menstruating women – inadequate iron 10% us- inadequate zinc inadequate intake=metabolic disruption, dna damage in vivo

• Vitamin and mineral supplements improve the intelligence scores and concentration of six-year-old children

There was a significant relationship between the amount of sugar diet and consumed in the improvement in intelligence scores when taking the vitamin/mineral supplement

Environmental Working Group

www.ewg.org

The Dirty Dozen

The Clean 15

Documentaries:

• Food Inc.

• The Killer at Large

• The Hidden Epidemic

• Life Over Cancer (book)

Home stretch!

“Herbals” and Depression

• St John's wort for major depressionKlaus Linde1, Michael M Berner2, Levente Kriston2 Editorial group: Cochrane Depression, Anxiety and Neurosis Group.Publication status and date: Edited (no change to conclusions), published in Issue 4, 2009.

29 trials 5489 px, hypericum extracts tested in the included trials a) are superior to placebo in patients with major depression; b) are similarly effective as standard antidepressants; c) and have fewer side effects than standard antidepressants

• Role of S-adenosyl-L-methionine in the treatment of depression: a review of the evidence

SAMe is superior to placebo and is as effective as tricyclic antidepressants in alleviating depression, although some individuals may require higher doses

“Herbals” and Anxiety

• Kava extract for treating anxiety Compared with placebo, kava extract as effective of the symptomatic treatment for anxiety although, at present, the size effect seems small, The data available from the reviewed studies suggest that kava is relatively safe for short-term treatment (1 to 24 weeks)

• Inositol treatment for panic disorder Pilot study using inositol for panic showed better than placebo response

Saguil Approach go-to’s for “mild symptoms”

• St Johns Wort• SAMe• Kava Kava• Inositol/Rhodiola

• Valerian• Melatonin

http://www.naturopathic.org/

http://www.ncbi.nlm.nih.gov/pubmed/http://scholar.google.comhttp://naturaldatabase.therapeuticresearch.comhttp://naturalstandard.com/http://www.usp.org/USPVerified/dietarySupplements/

In Summary:

• Whole foods using store rating systems • Omega 3 fish oil/flax seed oil • Supplement with multivitamins, D3! • Consider adding herbal (with help) • Seek out an Integrative Approach

2nd Tier Testing

• Specific food allergy testing• Autoimmune Panel• Hormone testing (Martin Ave Pharmacy)• Cortisol testing (Genova)• Heavy metal toxicity• Omega 3 level• Spectracell Testing• MRI• Stress Testing

Rating Systems

• ONQI (unhealthy/healthy=number) Grandpa (overall nutritional quality index)

• NuVal Meijer, Marianno’s Arlington Heights (www.nuval.com)

• ANDI/MANDI Whole Foods Market (www.eatrightamerica.com)

• Glycemic Index / Load Canada (http://www.glycemicindex.com)

• Color code Supervalu/Jewel Osco (know your chakra’s?)

First Tier Blood Testing at FHA

• Metabolic panel• CBC• Lipid• Thyroid panel (tsh, free t4, t3, thyroid antibody-iodine)

• Iron panel• B12, Folate, Vitamin D (25OH), Magnesium• IgG food sensitivity testing

QUESTIONS?

COMMENTS?CONCERNS?

Nutrition and Mental HealthRic Saguil, MD

2010 South Arlington Heights RoadArlington Heights, IL

Phone: 847-593-3330www.FirstHealthAssociates.com

Next lecture: Whole Foods Schaumburg June 18th, 200pm

Bibliography• Merikangas KR, He J, Burstein M, Swanson SA, Avenevoli S, Cui L, Benjet C, Georgiades K, Swendsen J. Lifetime prevalence of mental

disorders in U.S. adolescents: Results from the National Comorbidity Study-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry. 2010 Oct. 49(10):980-989.

• Higher Healthy Eating Index-2005 Scores Associated with Reduced Symptoms of Depression in an Urban Population: Findings from the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) Study

Marie Fanelli Kuczmarski, PhD, RD, LDN, Alexandra Cremer Sees, MS, RD Lawrence Hotchkiss, PhD Nancy Cotugna, DrPH, Journal of the American Dietetic Association Volume 110, Issue 3 , Pages 383-389, March 2010• Dietary pattern and depressive symptoms in middle age Tasnime N. Akbaraly, PhD The British Journal of Psychiatry (2009) 195: 408-413. doi: 10.1192/bjp.bp.108.058925• Longevity increased by positive self-perceptions of aging. By Levy, Becca R.; Slade, Martin D.; Kunkel, Suzanne R.; Kasl, Stanislav V. Journal of Personality and Social Psychology, Vol 83(2), Aug 2002, 261-270.• Fish Consumption and Depressive Symptoms in the General Population in Finland Antti Tanskanen, M.D., Joseph R. Hibbeln, M.D., Jaakko Tuomilehto, M.D., Antti Uutela, Ph.D., Ari Haukkala, M.Sc., Heimo Viinamäki, M.D., Johannes Lehtonen, M.D. and Erkki Vartiainen, M.D. Psychiatr Serv 52:529-531, April 2001 © 2001 American Psychiatric Association • St John's wort for major depression

Editorial group: Cochrane Depression, Anxiety and Neurosis Group.Publication status and date: Edited (no change to conclusions), published in Issue 4, 2009

• Role of S-adenosyl-L-methionine in the treatment of depression: a review of the evidence American Journal of Clinical Nutrition, Vol. 76, No. 5, 1158S-1161S, November 2002 © 2002 American Society for Clinical Nutrition• Kava extract for treating anxiety Cochrane Database of Systematic Reviews 2003, Issue 1. Art. No.: CD003383. DOI: 10.1002/14651858.CD003383

• Inhibiting and facilitating conditions of the human smile: A nonobtrusive test of the facial feedback hypothesis. Strack, Fritz; Martin, Leonard L.; Stepper, Sabine Journal of Personality and Social Psychology, Vol 54(5), May 1988, 768-777. doi: 10.1037/0022-3514.54.5.768• Power Posing: Brief Nonverbal Displays Affect Neuroendocrine Levels and Risk Tolerance Dana R. Carney1, Amy J.C. Cuddy2, and Andy J. Yap1 Psychological Science OnlineFirst, published on September 21, 2010 as doi:10.1177/0956797610383437• Respiratory feedback in the generation of emotion Philippot P.; Chapelle G.; Blairy S Cognition and Emotion, Volume 16, Number 5, 1 August 2002 , pp. 605-627(23• Body posture effects on self-evaluation: A self-validation approach Pablo Briñol1,*, Richard E. Petty2, Benjamin Wagner2

European Journal of Social Psychology Volume 39, Issue 6, pages 1053–1064, October 2009• Double-blind, placebo-controlled, crossover trial of inositol treatment for panic disorder J Benjamin, J Levine, M Fux, A Aviv, D Levy and RH Belmaker Am J Psychiatry 1995; 152:1084-1086 Copyright © 1995 by American Psychiatric Association • Omega-3 Treatment of Childhood Depression: A Controlled, Double-Blind Pilot Study Hanah Nemets, M.D., Boris Nemets, M.D., Alan Apter, M.D., Ziva Bracha, M.D., and R.H. Belmaker, M.D. Am J Psychiatry 163:1098-1100, June 2006 doi: 10.1176/appi.ajp.163.6.1098• The Metabolic Tune-Up: Metabolic Harmony and Disease Prevention Bruce N. Ames The American Society for Nutritional Sciences J. Nutr. 133:1544S-1548S, May 2003•

Vitamin and mineral supplements improve the intelligence scores and concentration of six-year-old children David Benton and Richard Cook Personality and Individual Differences Volume 12, Issue 11, 1991, Pages 1151-1158