Nutrition and mental health
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Dr Saguil, First Health Associates, nutrition, depression, bikram Yoga

Dr Saguil, First Health Associates, nutrition, depression, bikram Yoga

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  • Based on a survey of our patients, we found a consistent theme of what frustrates them about conventional medicine practices and why they felt First Health was different. Since identifying these 4 key areas, we have made a consistent effort to offer our absolute best to:Listen attentively to Patients concernsMake the patient the driving force as the center of careMinimize wait timesExplain all the options for treatment, and give the patient choices (medications, alternative medicine, nutritional medicine/supplementation, psychological medicine)
  • Design notes: list of providersWe want this to look much more inviting—these chairs are way too cold.Had thoughts about putting the actual providers in the chairs. Could be an actual live picture with a sample patient in the red chair or could be a group of providers sitting around the table.
  • Design notes: list of providersWe want this to look much more inviting—these chairs are way too cold.Had thoughts about putting the actual providers in the chairs. Could be an actual live picture with a sample patient in the red chair or could be a group of providers sitting around the table.

Nutrition and mental health Nutrition and mental health Presentation Transcript

  • Nutrition and Mental Health
    RicSaguil, MD
    Bikram Yoga Naperville
    May 2011
    We didn’t invent the practice of medicine….
    we’re just changing the way it’s provided.
  • First Health Associates
    2010 S. Arlington Heights Rd
    LL Suites
    Arlington Heights, IL
    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.
  • 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, MD
    Jason Gruss, MD
    Tom Jordan, RD
    Katrina Christie, LCPC
    Jennifer Green, ND
    Joe Musolino, DC
    Amy Iaquinta, DC
    Nick Nowicki, DC
    Emery Paredes, PT
    Courtney Day, EP
    Yu 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
    TricyclicsPamelor, 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!
  • Integrative
    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
  • Wellness Team
    Ric Saguil, MD
    Jason Gruss, MD
    Tom Jordan, RD
    Katrina Christie, LCPC
    Jennifer Green, ND
    Joe Musolino, DC
    Amy Iaquinta, DC
    Nick Nowicki, DC
    Emery Paredes, PT
    Courtney Day, EP
    Yu 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 thehighest tertile of the whole food pattern had
    lower odds ofCES–D depression /high consumptionof processed food was associated
    with an increased odds of CES–Ddepression
  • 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-wuweizi)
    Seeds (jujube seeds-suanzoaren, 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!
  • Fast
    slow
  • 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 associationbetween fish consumption
    anddecreaseddepressive symptoms in this populationsample 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
    Elimination Diet
    Detox 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 wortfor major depressionKlaus Linde1, Michael M Berner2, LeventeKriston2 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 ofS-adenosyl-L-methionine in the treatment of depression: a review of the evidence
    SAMeis 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)
    NuValMeijer, 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?
    Nutrition and Mental HealthRicSaguil, MD
    Next lecture: Whole Foods Schaumburg June 18th, 200pm
    COMMENTS?
    CONCERNS?
    2010 South Arlington Heights Road
    Arlington Heights, IL
    Phone: 847-593-3330www.FirstHealthAssociates.com
  • 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
    TasnimeN. 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
    AnttiTanskanen, M.D., Joseph R. Hibbeln, M.D., JaakkoTuomilehto, M.D., AnttiUutela, Ph.D., Ari Haukkala, M.Sc., HeimoViinamäki, M.D., Johannes Lehtonen, M.D. and ErkkiVartiainen, M.D.
    PsychiatrServ 52:529-531, April 2001 © 2001 American Psychiatric Association
    St John's wort for major depressionEditorial 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.; BlairyS
    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
    HanahNemets, M.D., Boris Nemets, M.D., Alan Apter, M.D., ZivaBracha, M.D., and R.H. Belmaker, M.D.
    Am J Psychiatry 163:1098-1100, June 2006doi: 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 DifferencesVolume 12, Issue 11, 1991, Pages 1151-1158