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Food for Body and Mind
Carolyn Denton, MA, LN
Perspectives in Nutrition
“Nutrients are the nourishing substances in food that
are essential for the growth, development and
maintenance of body functions. Essential meaning
that if a nutrient is not present, aspects of function
and therefore human health decline. When nutrient
intake does not regularly meet the nutrient needs
dictated by the cell activity, the metabolic
processes slow down or even stop”
Wardlaw and Insel
Nutrients
• Nourishing substances
• Each nutrient has a specific job or function in
the body.
• Nutrients act as cofactors, coenzymes,
triggers of other processes.
• Without nutrients metabolic processes slow
down or even stop.
Nutrient Support
• Immune System Function: vitamin A, vitamin E, zinc,
folic acid, vitamin B-6, riboflavin, magnesium, selenium,
vitamin C
• Nerve Impulses: sodium, potassium, magnesium,
calcium, vitamin B6, folic acid, B-12, copper, vitamin C
• Tissue Repair and Formation: vitamin A, vitamin E,
copper, riboflavin, magnesium, vitamin B6, vitamin C
• Metabolism: potassium, thiamin, niacin, vitamin B6,
magnesium, riboflavin, folic acid and vitamin C
Magnesium
Function
 Needed for healthy bones
 Initiates muscle release
 Promotes healthy blood
vessels
 May lower blood pressure
 Involved in temperature
regulation
 Needed for serotonin
production
 Involved in nerve
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transmission
Activates energy synthesis
Inhibits platelet
aggregation
Increases HDL cholesterol
Helps control blood sugar
Enhances immune function
Food is Information
Shift in Focus
• Food contains messages or directions to
the systems of the body about function.
• Function as single systems as well as
interconnected/interdependent systems.
• Focus should be on foods to include
rather than foods to exclude.
Functional Nutrition
• If a nutrient is not present over a period
of time, aspects of dysfunction then
give rise to symptoms, decline and the
development of disease.
• Dysfunction is a pre-disease state for
which intervention with nutrients or
“information” is needed to restore
function and thereby reduce risk of
chronic disease.
Functional Nutrition
• Looks for core underlying imbalances.
• Faulty digestion, impaired
detoxification, oxidative stress,
hormonal imbalances, altered immunity
and inflammation.
• Dysfunction and disease arise from diet,
nutrient balance, environment, trauma,
stress, attitude, beliefs, mind and spirit.
Dopamine
 Functionally creates a state of heightened arousal
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and alertness. Dopamine is excitatory.
Rapid movement
Learning
Mental focus
Cognition
Emotional significance
Relevance of an event
“Reward” neurotransmitter
Dopamine Imbalance
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ADD and ADHD
Parkinson’s
Restlessness, restless leg syndrome
Difficulty concentrating
Impulsivity
Anxiety
Addictive behaviors (cigarettes, alcohol, drugs)
Impatience and explosiveness
Unable to relax
Nutritional Influence
 Normal insulin signaling in the brain stimulates
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the release of dopamine.
Insulin resistance leads to the impairment of
dopamine release.
Zinc increase brain dopamine, thought that there
is a zinc deficiency in ADHD.
Tyrosine is a precursor to dopamine.
Theanine and alpha lipoic acid also increase
dopamine.
Vitamin B6, folic acid and B12 are necessary for
synthesis of dopamine.
Recipe for Dopamine
 Tyrosine found in black beans, pumpkin seeds, sesame
seeds, avocado
 Zinc found in oysters, wheat germ, cashews, cocoa powder
 Vitamin B6 found in bananas, spinach and white potatoes
 Folic acid found in orange juice, lentils, chickpeas and
asparagus
 Theanine found in green tea, black tea, plants
Serotonin
 Functionally, serotonin creates a sense of
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wellbeing. Serotonin is inhibitory.
Regulates comfort ‘rest and digest”
Regulates sleep
Influences mood
Promotes concentration and focus
Allows for social engagement
‘Let’s you feel good inside yourself”
Serotonin Imbalance
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Reduced appetite
Pain sensitivity
Negative thoughts, low self esteem
Sleep disorders
Hyper-vigilance
Depression, anxiety
PTSD (post-traumatic stress syndrome)
SAD (seasonal affective disorder)
OCD (obsessive compulsive disorder)
Nutritional Influence
 Ample dietary protein, specifically tryptophan.
 Vitamin C, vitamin B6, and folic acid are cofactors
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in the conversion of tryptophan to serotonin.
Magnesium is a cofactor for serotonin synthesis.
Vitamin B12 cofactor in neurotransmitter
methyalation.
Vitamin D influences the metabolism of serotonin.
Food that contains slowly absorbed carbohydrates
from whole grain provides long-lasting serotonin.
Recipe for Serotonin
 Tryptophan found in protein such as turkey, soybeans or
milk
 Vitamin C found in citrus fruits, tomatoes, kiwi, broccoli and
parsley
 Vitamin B6 found in bananas, spinach and white potatoes
 Folic acid found in orange juice, lentils, chickpeas and
asparagus
 Magnesium found in brown rice, hazelnuts and Swiss chard
 Carbohydrate found in whole grain such as wheat, oats and
quinoa
Glutamate
 Functionally, glutamate is the neurotransmitter of
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excitability.
The most abundant free amino acid in the central
nervous system.
Balances with GABA, interaction of excitation and
inhibition.
Controls pain perception
Plays a role in cellular memory
Influences learning processes
Excess glutamate causes cell death and
neurodegeneration.
Glutamate Imbalance
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Seizures
Migraine headaches
Parkinson’s
ALS (amyotrophic lateral sclerosis)
PTSD (post traumatic stress disorder)
Bipolar disorder Schizophrenia
Alzheimer's
Multiple Sclerosis
Autism
Nutritional Influences
 Mercury and other heavy metals increase
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glutamate.
Homocysteine, aracadonic acid and inflammatory
cytokines all increase glutamate.
Excessive sympathetic nervous system activation
(cortisol) increases glutamate.
Vitamin D blocks glutamate.
Taurine and Vitamin B6 convert glutamate to
GABA.
GABA
 Functionally, GABA (gamma aminobutyric acid)
calms the brain. It is the primary inhibitory
neurotransmitter.
 GABA plays a critical role in cell to cell
communication.
 GABA plays a role in sedation and anticonvulsant
activity.
GABA Imbalance
 Anxiety
 Depression
 Excessive worrying
 Insomnia and other sleep disturbances
 Panic attacks and restlessness
 Seizures
 Bipolar disorder
 PTSD (post traumatic stress disorder)
Nutritional Influences
 Taurine and vitamin B6 boost the production of
GABA.
 N-acetylcysteine (NAC) influences GABA.
 Calming herbs such as passionflower and valerian
promote GABA production.
 L-theonine found in green tea and oolong tea
increases GABA.
Inflammation
 During the past decade inflammation has been
revisited as an important etiological factor of
mood disorders.
 Review looked at the evidence for an association
between inflammation and mood disorders.
 Discussed the induction of a proinflammatory
state in healthy or medically ill subject induces
“sickness behavior” resembling depressive
symptomology.
Inflammation
 Potential mechanisms include effects of pro-
inflammatory cytokines on monoamine levels,
dysregulation of the HPA axis, impaired
neuroplasticity, and structural and functional brain
changes.
 Agents include anti-inflammatory agents such as
acetylsalicylic acid (ASA), celecoxib, anti-TNF-a
agents, minocycline, curcumin and omega-3 fatty
acids.
Progress in Neuro-Psychopharmacology & Biological Psychiatry, 2014
Inflammation
 Chronic exposure to elevated inflammatory
cytokines and persistent alterations in
neurotransmitter systems can lead to neuropsychiatric disorders and depression.
 Mechanisms of cytokine behavioral effects involve
activation of inflammatory signaling pathways in
the brain that results in changes in monoamine,
glutamate, and neuropeptide systems, and
decreases in growth factors, such as brain-derived
neurotrophic factor.
Inflammation
 Medically healthy depressed patients who are
resistant to antidepressant therapy demonstrate
higher concentrations of circulating inflammatory
cytokines and CRP than patients who respond to
antidepressants.
 Baseline concentrations of circulating cytokines,
such as IL-6, and markers of inflammation, like
CRP, may be useful for indentifying subjects that
will fail to respond to current antidepressant
therapies and for determining potential novel
treatment strategies.
Neuroscience, 2013
Inflammation
 So depression is an inflammatory disease, but where does it
come from?
 A range of factors appear to increase the risk for the
development of depression and seem to be associated with
inflammation including psychosocial stressors, poor diet,
physical inactivity, obesity, smoking, altered gut
permeability, atopy, dental caries, sleep and vitamin D
deficiency.
 Identifying sources of inflammation and with quality
evidence linking depression to these factors provides
mechanistic support. The pivotal element is that most of
these factors are plastic and amenable to intervention both
therapeutic and preventive. Prevention being the most
pressing.
BMC Medicine, 2013
Fatty Acids
 Fatty acids are of highest concentration in brain
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membranes
Phospholipids are the most critical membrane lipid
and are composed of polyunsaturated fatty acids
including omega 3 and omega 6.
Lipid composition is critical to how a message is
received.
Neuronal membranes are either stabilized or
destabilized by fatty acids.
Fatty acids modulate neurotransmission and
reduce excitability.
Fatty Acids
Fatty acid deficiency:
 Learning disabilities and delay in development.
 Reduced visual acuity and tracking.
 Increase in aggressive behavior.
 Risk of other neurological issues.
 Risk of depressive disorders.
 Increases brain inflammation. Cytokines break
down tryptophan and force it into a pathway
toward glutamate, away from serotonin synthesis.
Fatty Acids
 One of the most promising research fields is the
inflammatory component of major psychiatric diseases
(depression, bipolar disorders and schizophrenia).
 Four major classes of anti-inflammatory drugs were
identified, namely polyunsaturated fatty acids (PUFAs),
cyclooxygenase (COX) inhibitors, anti-TNFalpha and
minocycline.
 Further studies are warranted to identify more precisely the
biomarkers that could identify potential responders and
orientate some specific treatment.
 The benefit/risk ratio of add-on-anti-inflammatory drugs
should always be discussed Omega-3 may have the better
benefit/risk ratio in depressive disorders as no severe sideeffects have been described to date.
Acta Psychiatrica Scandinavica, 2013
Fatty Acids
• A number of epidemiological and preclinical studies have
proven the potential benefit and critical role of omega-3
PUFA in the development and management of major
depressive disorder (MDD).
• Article presents an overview of the evidence to date about
the clinical application and biological mechanisms of omega3 PUFA in the treatment of MDD.
• Given the potential action mechanism, clinical benefits and
currently available clinical trial data, omega-3 PUFAs may
deserve greater attention and wider application for
treatment of MDD.
Expert Opinion on Investigational Drugs, 2013
Fatty Acids
 Increasing evidence from the fields of neurophysiology and
neuropathology has uncovered the role of polyunsaturated
fatty acids (PUFA) in protecting neuronal cells from oxidative damage, controlling inflammation, regulating
neurogenesis, and preserving neuronal function.
 This review article outlines the role of PUFA in
neurodevelopment and the regulatory mechanisms in
neuronal stem cell differentiation and also the possible use
of PUFA as a prescription medicine for the prophylaxis or
treatment of neuropsychiatric illnesses such as dementia,
mood disorder, and PTSD.
Journal of Pharmacological Sciences, 2014
The Stress Response
• Fight or flight
Sympathetic nervous
system stimulated
• Parasympathetic nervous
system is over-ridden.
• Pupils dilate
• Blood pressure rises
• Digestion suppressed
• Immunity suppressed
• Detoxification suppressed
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Glucose released
Cholesterol released
Fluid retained
Fat is deposited
Decreased energy
Hormones deranged
Mood fluctuations
Inflammatory mediators
stimulated
• Gradual demineralization
of bone
Stress and Inflammation
 Stressful life events can bring about symptoms of a
depressed mood through physically damaging the brain.
 This damage triggers a repair response (not unlike any
wound repair) that includes inflammation. The changes
caused by these inflammatory messengers may lead to
physical pain and depression of normal function during the
repair process.
 When these repair processes continue for longer periods,
due to ongoing stress or an inability to fully repair, then
depressive symptoms can become chronic.
Neuroscience and Behavioral Reviews. 2011
“There is nothing bad or good but
thinking makes it so” Shakespeare
• Key mediator of stress response is appraisal.
• The physical stress response varies depending on
interpretation and perception.
• When unconscious attention is tied up in “fight or flight”
the result is mental, emotional and metabolic patterns
of excess and depletion.
• Ability to downshift out of SNS and promote PNS
dominance is critical.
Case Presentation
• 45 year old woman depressed since age 12
• First severe episode in college
• Recurrent, estimates she is depressed 25% of
time
• PMDD Pattern
• Seasonal Pattern
• Strong family history: mother and 3 sisters with
depression
Core Symptoms
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Sad, depressed and irritable mood
Loss of interest, pleasure, motivation
Poor concentration, distractible
Energy sluggish
Sleeps excessive-10 hours, not restored
Ruminative thought, negative self-talk
Shame, low self esteem
Isolated, few significant relationship
Treatment History
• Psychotherapy
– On and off for year
– Had long-term therapy with benefit but without
change in her pattern of depression
• Medication
– Several, including SSRI and Wellbutrin
– Good response to Zoloft, but effects wore off
– Doses increased with temporary improvement
– Unpleasant withdrawal, even if missed one dose
Stress
• Work Stress
• Parents’ divorce, fighting during childhood,
father is estranged
• Loss of 3 significant relationships (triggering
her most severe episodes)
• Feels alone, wearing out her supports
Relevant Medical History
• Juvenile Rheumatoid Arthritis
• Current joint pain
• Psoriasis
• Severe acne as a teen
• IBS, mild reflux, loose stools
Relevant Medical History
• Eats well. Craves sugar, occasional binging
• Weight gain
• Sisters and mother are diabetic
• Sisters and mother are obese
• Paternal alcohol dependence
Nutritional Intervention
• Discussed blood sugar metabolism and the
physiology of potential insulin resistance.
• Reviewed the guidelines for insulin/glucose
balance.
• Recommended alpha lipoic acid and chromium.
• Additionally described how stress both internal
and external can contribute to such an imbalance.
Nutritional Intervention
• Conducted a modified elimination challenge to
determine potential food sensitivity or
intolerance.
• After the four week challenge subject was found
to have sensitivities to wheat and corn.
• Felt terrific without these foods, eczema cleared,
joint pain diminished, bowels normalized and she
felt less anxious.
• Recommended omega-3 fatty acids and turmeric
(curcumin) to help as anti-inflammatory agents.
Nutritional Intervention
 Discussed estrogen metabolism.
 Discussed the sleep cycle.
 Discussed the stress response. Participant
in program for depression based on the
work of Dr. Henry Emmons called
Resilience Training.
Outcome
• “I feel like the cloud lifted.”
• Mood stable.
• Energy improved.
• Digestive system normalized.
• Sleeps less, feels more rested.
• Achiness in body and “heart” gone.
• Said, “This is the first winter I have not
been depressed in my entire life.”