Nutrition and Mental Health<br />RicSaguil, MD<br />Bikram Yoga Naperville<br />May 2011<br />We didn’t invent the practic...
First Health Associates<br />2010 S. Arlington Heights Rd<br />LL Suites<br />Arlington Heights, IL<br />My Doctor:<br /><...
Cares what I have to say
Doesn’t Keep Me Waiting
Gives Me Options</li></ul>We didn’t invent the practice of medicine….<br /> 		we’re just changing the way it’s provided.<b...
The First Health Approach<br />We didn’t invent the practice of medicine….<br /> 		we’re just changing the way it’s provid...
Your Community<br /> of Care<br />Ric Saguil, MD<br />Jason Gruss, MD<br />Tom Jordan, RD<br />Katrina Christie, LCPC<br /...
Physiology 101<br />Jill Bolte Taylor<br />
You’ve got nerve!<br />
The extension cords<br />
Where the music happensThe Synapse<br />
How medicines help<br />
Drug Classes<br />SSRI           Lexapro, Prozac, Zoloft, Paxil, Effexor<br />MAOI        Marplan, Parnate, Nardil<br />Tr...
Top 5 classes of drugs purchased ‘08<br />Cardiovscular<br />Central Nervous System<br />Metabolic Agent<br />Hormones/Hor...
Top 5 Psych Drugs 2009<br />Xanax                     44,029,000                    A<br />Lexapro                  27,698...
“My Bad”<br />
Congrats!<br />You now know the standard medicine approach!<br />
Integrative<br />The Saguil Approach<br />History (more than 7 minutes)<br />Search for other causes       Thyroid<br />  ...
Wellness Team<br />Ric Saguil, MD<br />Jason Gruss, MD<br />Tom Jordan, RD<br />Katrina Christie, LCPC<br />Jennifer Green...
Food and mood<br />Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) Study<br />     1,118 30-64 y...
Whole Foods Healing (from Healing with Whole Foods)<br />Oyster shell (ca++)<br />Grain (whole wheat, brown rice, oats)<br...
Why “whole foods”<br />
Why not processed?<br />
Glycemic Index Theory and Processed Foods<br />
Work it sugar!<br />
Fast<br />slow<br />
Fast spikes in blood glucose =<br />Fast drop in blood glucose<br />
The First Health Performance Diet<br />High Powered Oat Breakfast (Oatmeal, Flaxseed, Walnuts, Apples, Cinnamon)<br />Gree...
Whole Foods<br />Non Processed Foods<br />Healthy fats (O3) <br />Fruits and Vegetables (7-10?)<br />Legumes<br />Grain (f...
Omega 3<br />Fish Consumption and Depressive Symptoms in the General Population in Finland 3204 sampled<br />       result...
Fatty Facts:<br />ALA          short chain fatty acids<br />EPA DHA long chain fatty acids<br />Conversion from ALA to E a...
Organic when you can<br />
“Low and slow” exposure  to allergen<br />Elimination Diet<br />Detox Diet<br />
Piggy back products in/on your food<br />Bacteria <br />Pesticides<br />Mercury<br />Antibiotics<br />Hormones <br />Genet...
Go broke with Organics?        Pay up now or pay up later                                                                 ...
Environmental Working Group<br />    www.ewg.org<br />The Dirty Dozen<br />The Clean 15<br />
Documentaries:<br />Food Inc. <br />The Killer at Large<br />The Hidden Epidemic<br />Life Over Cancer (book)<br />
Home stretch!<br />
“Herbals”and Depression<br />St John's wortfor major depressionKlaus Linde1, Michael M Berner2, LeventeKriston2 Editorial ...
“Herbals”and Anxiety<br />Kava extract for treating anxiety<br />Compared with placebo, kava extract as effective of the <...
Saguil Approach go-to’s for “mild symptoms”<br />St Johns Wort<br />SAMe<br />Kava Kava<br />Inositol/Rhodiola<br />Valeri...
http://www.ncbi.nlm.nih.gov/pubmed/http://scholar.google.comhttp://naturaldatabase.therapeuticresearch.comhttp://naturalst...
In Summary:<br /><ul><li>Whole foods using store rating systems
Omega 3 fish oil/flax seed oil
Supplement with multivitamins, D3!
Consider adding herbal (with help)
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Nutrition and mental health

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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

    1. 1. Nutrition and Mental Health<br />RicSaguil, MD<br />Bikram Yoga Naperville<br />May 2011<br />We didn’t invent the practice of medicine….<br /> we’re just changing the way it’s provided.<br />
    2. 2. First Health Associates<br />2010 S. Arlington Heights Rd<br />LL Suites<br />Arlington Heights, IL<br />My Doctor:<br /><ul><li>Listens to my concerns
    3. 3. Cares what I have to say
    4. 4. Doesn’t Keep Me Waiting
    5. 5. Gives Me Options</li></ul>We didn’t invent the practice of medicine….<br /> we’re just changing the way it’s provided.<br />
    6. 6. The First Health Approach<br />We didn’t invent the practice of medicine….<br /> we’re just changing the way it’s provided.<br />
    7. 7. Your Community<br /> of Care<br />Ric Saguil, MD<br />Jason Gruss, MD<br />Tom Jordan, RD<br />Katrina Christie, LCPC<br />Jennifer Green, ND<br />Joe Musolino, DC<br />Amy Iaquinta, DC<br />Nick Nowicki, DC<br />Emery Paredes, PT<br />Courtney Day, EP<br />Yu Zhu, MD China<br />Mike Blumberg, LCPC<br />You<br />
    8. 8. Physiology 101<br />Jill Bolte Taylor<br />
    9. 9. You’ve got nerve!<br />
    10. 10. The extension cords<br />
    11. 11. Where the music happensThe Synapse<br />
    12. 12. How medicines help<br />
    13. 13. Drug Classes<br />SSRI Lexapro, Prozac, Zoloft, Paxil, Effexor<br />MAOI Marplan, Parnate, Nardil<br />TricyclicsPamelor, Norpramin, Tofranil, Amytriptyline<br />Atypical Abilify, Risperidal, Geodon, Zyprexa, Seroquel<br />Other Classes Wellbutrin, Lamictal, Depakote<br />
    14. 14. Top 5 classes of drugs purchased ‘08<br />Cardiovscular<br />Central Nervous System<br />Metabolic Agent<br />Hormones/Hormone Modifiers<br />Psychotherapeutic Agents<br />206,294,564 purchases, 27,953,909 buyers<br />Medical Expenditure Panel Survey US Dept Health and Human Svs<br />
    15. 15. Top 5 Psych Drugs 2009<br />Xanax 44,029,000 A<br />Lexapro 27,698,000 A/D<br />Ativan 25,868,000 A<br />Zoloft 19,500,000 D<br />Prozac 19,499,000 D/A<br />Desyrel 18,873,000 D/A<br />Cymbalta 16,626,000 D/A<br />Seroquel 15,814,000 D/A<br />
    16. 16. “My Bad”<br />
    17. 17. Congrats!<br />You now know the standard medicine approach!<br />
    18. 18. Integrative<br />The Saguil Approach<br />History (more than 7 minutes)<br />Search for other causes Thyroid<br /> Adrenal<br /> Nutritional Deficiency<br /> Metal Toxicity<br /> Food Allergy<br /> Abuse(teen)<br /> Rheumatologic (autoimmune)<br /> FMS (CRPS)<br /> Coexisting Mental Disorder LD/ADD<br /> PMS<br /> Drug Side Effects<br />Behavioral Therapy Positive Psychology , CBT, EMDR(Imvmtdesensreprossg)<br />Herbal/Homeopathic<br />Medical Acupuncture<br />Nutritional Medicine <br />
    19. 19. Wellness Team<br />Ric Saguil, MD<br />Jason Gruss, MD<br />Tom Jordan, RD<br />Katrina Christie, LCPC<br />Jennifer Green, ND<br />Joe Musolino, DC<br />Amy Iaquinta, DC<br />Nick Nowicki, DC<br />Emery Paredes, PT<br />Courtney Day, EP<br />Yu Zhu, MD China<br />Mike Blumberg, LCPC<br />You<br />
    20. 20. Food and mood<br />Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) Study<br /> 1,118 30-64 y/o Baltimore MD 24hr diet recall= diet quality significantly associated<br /> with symptoms of depression<br />Dietary pattern and depressive symptoms in middle age<br />3486 participants participants in thehighest tertile of the whole food pattern had <br /> lower odds ofCES–D depression /high consumptionof processed food was associated <br />with an increased odds of CES–Ddepression<br />
    21. 21. Whole Foods Healing (from Healing with Whole Foods)<br />Oyster shell (ca++)<br />Grain (whole wheat, brown rice, oats)<br />Mushrooms (chinese as an immune tonic)<br />Silicon foods (barley gruel, cucumber, celery, lettuce, celery/lettuce juice all to improve calcium metab)<br />Fruit (lemons, schisandra berries-wuweizi)<br />Seeds (jujube seeds-suanzoaren, chia)<br />Spices (dill, basil)<br />Herbs (chamomile, catnip, scullcap, valerian)<br />Animal Products (quality cow and goat milk, clarified butter-ghee)<br />
    22. 22. Why “whole foods”<br />
    23. 23. Why not processed?<br />
    24. 24. Glycemic Index Theory and Processed Foods<br />
    25. 25.
    26. 26. Work it sugar!<br />
    27. 27. Fast<br />slow<br />
    28. 28. Fast spikes in blood glucose =<br />Fast drop in blood glucose<br />
    29. 29.
    30. 30. The First Health Performance Diet<br />High Powered Oat Breakfast (Oatmeal, Flaxseed, Walnuts, Apples, Cinnamon)<br />Greek Yogurt (140 cal, 14g protein)<br />PVC Lunch: Turkey Sandwich, Vegetable Soup<br />Afternoon Go-To: <br />Cottage Cheese + Fruit<br />Almonds + Cheese Stick<br />Paleoshake (protein, almond milk, frozen fruit)<br />PVC Dinner: 4oz Salmon, 1c Broccoli, Sweet Potatoes, 2 cups Spinach salad w/ Balsamic<br />Tom Jordan, RD<br />
    31. 31. Whole Foods<br />Non Processed Foods<br />Healthy fats (O3) <br />Fruits and Vegetables (7-10?)<br />Legumes<br />Grain (fiber)<br />Tea(green)<br />Fish/chicken (for beef/pork)<br />
    32. 32. Omega 3<br />Fish Consumption and Depressive Symptoms in the General Population in Finland 3204 sampled<br /> results showed a relatively powerful and independent associationbetween fish consumption<br />anddecreaseddepressive symptoms in this populationsample of 3,402 Finnish adults<br />Omega-3 Treatment of Childhood Depression: A Controlled, Double-Blind Pilot Study<br />Omega 3 fatty acids may have therapeutic benefits in childhood depression<br />
    33. 33. Fatty Facts:<br />ALA short chain fatty acids<br />EPA DHA long chain fatty acids<br />Conversion from ALA to E and D depends on <br /> how much omega 6 is in diet<br />Proper ration omega 6/omega 3 = 1:1 1:4<br /> US diet 10:1 20:1<br />3 gm EPA/DHA daily safe<br />Alcohol, US diet, Stress (amphetamine/dopamine depleation)<br />
    34. 34. Organic when you can<br />
    35. 35. “Low and slow” exposure to allergen<br />Elimination Diet<br />Detox Diet<br />
    36. 36. Piggy back products in/on your food<br />Bacteria <br />Pesticides<br />Mercury<br />Antibiotics<br />Hormones <br />Genetic contaminants (GMO)<br />It may not be your allergic, could be your toxic<br />
    37. 37. Go broke with Organics? Pay up now or pay up later US soil not as good as before<br />The Metabolic Tune-Up: Metabolic Harmony and Disease Prevention<br />25% menstruating women – inadequate iron<br /> 10% us- inadequate zinc<br /> inadequate intake=metabolic disruption, dna damage in vivo<br />Vitamin and mineral supplements improve the intelligence scores and concentration of six-year-old children <br />There was a significant relationship between the amount of sugar diet and <br />consumed in the improvement in intelligence scores when taking the <br /> vitamin/mineral supplement<br />
    38. 38. Environmental Working Group<br /> www.ewg.org<br />The Dirty Dozen<br />The Clean 15<br />
    39. 39. Documentaries:<br />Food Inc. <br />The Killer at Large<br />The Hidden Epidemic<br />Life Over Cancer (book)<br />
    40. 40. Home stretch!<br />
    41. 41. “Herbals”and Depression<br />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<br />Role ofS-adenosyl-L-methionine in the treatment of depression: a review of the evidence<br />SAMeis superior to placebo and is as effective as tricyclic <br />antidepressants in alleviating depression, although some<br />individuals may require higher doses<br />
    42. 42. “Herbals”and Anxiety<br />Kava extract for treating anxiety<br />Compared with placebo, kava extract as effective of the <br />symptomatic treatment for anxiety although, at present, the <br /> size effect seems small, The data available from the reviewed<br />studies suggest that kava is relatively safe for short-term<br />treatment (1 to 24 weeks)<br />Inositol treatment for panic disorder<br />Pilot study using inositol for panic showed better than placebo<br />response<br />
    43. 43. Saguil Approach go-to’s for “mild symptoms”<br />St Johns Wort<br />SAMe<br />Kava Kava<br />Inositol/Rhodiola<br />Valerian<br />Melatonin<br />http://www.naturopathic.org/ <br />
    44. 44. http://www.ncbi.nlm.nih.gov/pubmed/http://scholar.google.comhttp://naturaldatabase.therapeuticresearch.comhttp://naturalstandard.com/http://www.usp.org/USPVerified/dietarySupplements/<br />
    45. 45. In Summary:<br /><ul><li>Whole foods using store rating systems
    46. 46. Omega 3 fish oil/flax seed oil
    47. 47. Supplement with multivitamins, D3!
    48. 48. Consider adding herbal (with help)
    49. 49. Seek out an Integrative Approach</li></li></ul><li>2nd Tier Testing<br />Specific food allergy testing<br />Autoimmune Panel<br />Hormone testing (Martin Ave Pharmacy)<br />Cortisol testing (Genova)<br />Heavy metal toxicity<br />Omega 3 level<br />Spectracell Testing<br />MRI<br />Stress Testing<br />
    50. 50. Rating Systems<br />ONQI (unhealthy/healthy=number) Grandpa<br /> (overall nutritional quality index)<br />NuValMeijer, Marianno’s Arlington Heights<br /> (www.nuval.com)<br />ANDI/MANDI Whole Foods Market<br /> (www.eatrightamerica.com)<br />Glycemic Index / Load Canada<br /> (http://www.glycemicindex.com)<br />Color code Supervalu/Jewel Osco (know your chakra’s?)<br />
    51. 51. First Tier Blood Testing at FHA<br />Metabolic panel<br />CBC<br />Lipid<br />Thyroid panel (tsh, free t4, t3, thyroid antibody-iodine)<br />Iron panel<br />B12, Folate, Vitamin D (25OH), Magnesium<br />IgG food sensitivity testing<br />
    52. 52. QUESTIONS?<br />Nutrition and Mental HealthRicSaguil, MD<br />Next lecture: Whole Foods Schaumburg June 18th, 200pm<br />COMMENTS?<br />CONCERNS?<br />2010 South Arlington Heights Road<br />Arlington Heights, IL<br />Phone: 847-593-3330www.FirstHealthAssociates.com<br />
    53. 53. Bibliography<br />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.<br />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<br /> Marie Fanelli Kuczmarski, PhD, RD, LDN, Alexandra Cremer Sees, MS, RD Lawrence Hotchkiss, PhD Nancy Cotugna, DrPH, <br /> Journal of the American Dietetic Association<br /> Volume 110, Issue 3 , Pages 383-389, March 2010<br />Dietary pattern and depressive symptoms in middle age<br />TasnimeN. Akbaraly, PhD The British Journal of Psychiatry (2009) 195: 408-413. doi: 10.1192/bjp.bp.108.058925<br /> Longevity increased by positive self-perceptions of aging.<br /> By Levy, Becca R.; Slade, Martin D.; Kunkel, Suzanne R.; Kasl, Stanislav V.<br /> Journal of Personality and Social Psychology, Vol 83(2), Aug 2002, 261-270.<br />Fish Consumption and Depressive Symptoms in the General Population in Finland<br />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. <br />PsychiatrServ 52:529-531, April 2001 © 2001 American Psychiatric Association<br />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<br />Role of S-adenosyl-L-methionine in the treatment of depression: a review of the evidence<br />American Journal of Clinical Nutrition, Vol. 76, No. 5, 1158S-1161S, November 2002 © 2002 American Society for Clinical Nutrition<br /> Kava extract for treating anxiety<br />Cochrane Database of Systematic Reviews 2003, Issue 1. Art. No.: CD003383. DOI: 10.1002/14651858.CD003383<br />
    54. 54. Inhibiting and facilitating conditions of the human smile: A nonobtrusive test of the facial feedback hypothesis.<br />Strack, Fritz; Martin, Leonard L.; Stepper, Sabine <br /> Journal of Personality and Social Psychology, Vol 54(5), May 1988, 768-777. doi: 10.1037/0022-3514.54.5.768<br />Power Posing: Brief Nonverbal Displays Affect Neuroendocrine Levels and Risk Tolerance<br />Dana R. Carney1, Amy J.C. Cuddy2, and Andy J. Yap1<br />Psychological Science OnlineFirst, published on September 21, 2010 as doi:10.1177/0956797610383437<br /> Respiratory feedback in the generation of emotion<br />Philippot P.; Chapelle G.; BlairyS<br />Cognition and Emotion, Volume 16, Number 5, 1 August 2002 , pp. 605-627(23<br />Body posture effects on self-evaluation: A self-validation approach<br />Pablo Briñol1,*, Richard E. Petty2, Benjamin Wagner2<br />European Journal of Social Psychology Volume 39, Issue 6, pages 1053–1064, October 2009<br />Double-blind, placebo-controlled, crossover trial of inositol treatment for panic disorder<br />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 <br />Omega-3 Treatment of Childhood Depression: A Controlled, Double-Blind Pilot Study<br />HanahNemets, M.D., Boris Nemets, M.D., Alan Apter, M.D., ZivaBracha, M.D., and R.H. Belmaker, M.D. <br />Am J Psychiatry 163:1098-1100, June 2006doi: 10.1176/appi.ajp.163.6.1098<br />The Metabolic Tune-Up: Metabolic Harmony and Disease Prevention<br />Bruce N. Ames<br />The American Society for Nutritional Sciences J. Nutr. 133:1544S-1548S, May 2003<br />Vitamin and mineral supplements improve the intelligence scores and concentration of six-year-old children <br />David Benton and Richard Cook<br />Personality and Individual DifferencesVolume 12, Issue 11, 1991, Pages 1151-1158 <br />

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