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Ancestral Health Symposium from Dr Emily Deans, M.D. and Jamie Scott.

Ancestral Health Symposium from Dr Emily Deans, M.D. and Jamie Scott.

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  • Psychosocial work environment: managing work demands and personal control, balancing effort and reward, supporting respect and trust in the workplace.

An Evolutionary Pathway to Optimal Mental and Physical Health Presentation Transcript

  • 1. ResiliencyAn Evolutionary Pathway to Optimal Mental and Physical Health
  • 2. Emily Deans, M.D.
    Clinical Instructor in Psychiatry at Harvard Medical School
    evolutionarypsychiatry.blogspot.com
    Featured blogger on Psychology Today at Evolutionary Psychiatry
    Disclosures: None
    Participated in research funded by NIH
  • 3. Jamie Scott
    PGDipNutMed PGDipSportExMed BSc BPhEd
    Workplace Health Educator
    Nutritionist/Trainer
    thatpaleoguy.blogspot.com
    Disclosures: None
  • 4. Why Evolutionary Medicine for Mental Health?
    Existing treatments, therapy and medication, are only partially effective.
    They take a long time, are expensive, or have side effects.
    No truly novel treatments in 20 years, despite an explosion in neuroscience knowledge since 1990.
    We need a new approach
  • 5. Diseases of Civilization (DOC)
    Related to differences in our current lifestyle compared to our hunter gatherer past.
    Ultimate pathology of disease is inflammation – true of obesity, autoimmune disease, heart disease, acne… and mental illness.
    A clue we are dealing with DOC – the recent appearance and/or acceleration of change in illness in recent industrial history.
  • 6. Mental Health
    Schizophrenia
    Wither hebephrenia?
    MDD and Anxiety
    Increasing in prevalence and changing in morphology
    (Stanley Jackson Melancholia and Depression)
    Bipolar Disorder
    In last 40 years age of onset decreased from 30s to late teens, now more resistant to lithium, more rapid cycling (Fred Goodwin)
  • 7. Mental Health
    Eating Disorders
    Now more common in women and men; striking younger cohorts
    (NIH National Comorbidity Study)
    Autism
    Increasing?
    Yale SK study, teachers
    Dementia
    Definitely increasing, but is it just due to aging population?
  • 8. What Causes Mental Illness?
    Genes
    + Stress
    + Diet
    Changes to our modern, industrial, nutrient-poor diets have reduced our resiliency to stress
  • 9. What really causes mental illness?
    Genes
    Typically two, three, or more in a single signaling pathway (NRG-erbB in schizophrenia)
    One gene - no increased risk
    Two genes - 8-fold increased risk
    Three genes - 27-fold increased risk
    The suspect genes (for schizophrenia, autism, anxiety, depression, etc.) oftenreside in the stress response pathway
  • 10. Recipe for a brittle brain
    Suboptimal genes, plus…
    • Stress;
    • 11. Inflammation and poor immunity (includes gut);
    • 12. Micronutrient deficiency;
    • 13. Deranged sleep (cause or effect?);
    • 14. Lack of recovery and repair
  • Recipe for a resilient brain
    Eat a diet with reduced food toxins and one likely to promote a happy gut
    Avoid the Neolithic Agents of Disease
    Fermented foods to avoid inflammation
    Avoid autoimmune reactions
    Keep the immune system strong to suppress or avoid infection…
    Viruses and intracellular pathogens associated with worse cognitive functioning or greater severity of symptoms in schizophrenia, dementia, and mood disorders
    NOT FDA APPROVED
  • 15. Recipe for a resilient brain
    Eat a nutrient rich diet
    Magnesium is typically low in modern diets and plays a role modulating and reducing every part of the stress response.
    Zinc needs higher during stress.
    Phospholipids also seem to modulate stress response, choline can be especially low in modern diets
    Periods of fasting to promote ketosis, mitochondrial decommission, nerve plasticity and repair
    Sleep, play, love, exercise
    NOT FDA APPROVED
  • 16. Research Evidence
    Randomized Controlled Trials (RCT) of EvoMed lifestyle and diet for treatment of mental illness…
    THERE. ARE. NONE.
    The research has not been done.
    I blog in an effort to raise awareness.
  • 17. Evidence – a few shining jewels
    RCT of children with ADHD and food elimination diet
    Small trials of ketogenic diets in autism and dementia
    Diet and Violence studies
    Geschfound the prisoners were eating the RDA- topped them off with additional micronutrients violence decreased, study was replicated, mechanism remains mysterious
    Australian dietary pattern studies
    Depression and Bipolar disorder
    “Traditional” beats out “Modern” and “Western” patterns
    Many more in the constellation of studies I mention on my blog
  • 18. The Future
    A holistic, evolutionary medicine approach could not only revolutionize mental health treatment, but be preventative for the population.
  • 19. The Application of Evolutionary Biology to Corporate Health & Wellness Programmes
    New Zealand Market
  • 20.
  • 21. The Reality of the Corporate Environment
    Constant pressure to do more with less
    Absenteeism + Presenteeism
    High cost of employee recruitment + replacement
    Human biology rarely given a second thought
  • 22. International Wellness Landscape - What is driving a wellness focus
  • 23. International Wellness Landscape - Top Wellness Elements
  • 24.
  • 25. International Wellness Landscape - Fastest growing wellness elements
  • 26.
  • 27. Dr Emily Deans: What Causes Mental Illness?
    Genes
    + Stress
    + Diet
    Changes to our modern, industrial, nutrient-poor diets have reduced our resiliency to stress
  • 28. What Causes Low Resiliency to Work Stress?
    Genes?
    + Stress
    + Diet
    Plus other lifestyle factors
  • 29. Over-exposure to neolithic agents of disease
    Under-exposure to nutrient-dense foods
    Over-exposure to sedentariness and/or ‘chronic cardio’
    Under-exposure to evolutionary-appropriate physical activity
    Over-exposure to artificial lighting
    Under-exposure to natural lighting
    Deranged sleep patterns and a disconnect with circadian rhythms
    Disconnect with evolutionary-appropriate socialisation
    H.R. APPROVED
  • 30. Our evolution designed us for a world very different from that we have constructed for ourselves. Within a mere instant, in evolutionary terms, we have transformed our environment.
    But this widening mismatch between our biology and our environment has its costs. And we cannot evolve our way out of the problem.
    Mismatch - why our world no longer fits our bodies (Oxford Press, 2006).
    Prof Peter Gluckman and Mark Hanson
  • 31. Greatest capacity for adaptation?
    Soft biological object
    Rigid inanimate objects
  • 32. Our Current Focus
    Creating awareness around how our biology impacts on;
    • health and well-being
    • 33. stress resiliency
    • 34. work productivity
  • Building Resilience
  • 35.
  • 36. Some of the Challenges Ahead…
    Conventional wisdom entrenchment
    The perceived authority of those delivering information
    Evolutionary model is ‘novel’ compared to conventional wisdom - needs to be proven as an intervention
    Status quo is path of least resistance (cost)
    Lack of support services… doctors, nutritionists, trainers
    Perception of ‘paleo re-enactment’…
  • 37.
  • 38. Future Hopes and Dreams…
    Evolutionary biology becomes the default model, with the onus shifting to those outside of this model to justify their approach with a robust level of evidence…
    More focus shifted to how to integrate evolutionary biology rather than why we should…
    More adaptation of the physical work environment to the soft squishy objects…
    Growth of a support services network(e.g. PPN)
  • 39. PHOTO CREDITS
    Slides 2+3; Emily Deans and Jamie Scott
    Slide 6; Wikimedia Commons
    All other slides; images licensed from iStock
    REFERENCES - Emily Deans, M.D.
    Crystal HA, Dickson D, Davies P, Masur D, Grober E, Lipton RB: The relative frequency of “dementia of unknown etiology” increases with age and is nearly 50%in nonagenarians. Arch Neurol 2000, 57:713-719.
    Eby, George A, Eby, Karen L.  Rapid recovery from major depression using magnesium treatment.  Med Hypotheses. 2006;67(2):362-70
    Evangeliou, Athanasios MD. Application of a Ketogenic Diet in Children With Autistic Behavior: Pilot Study.  J Child Neurol February 2003 vol. 18no. 2 113-118
    Eves A, Gesch B, Food provision and the nutritional implications of food choices made by young adult males, in a young offenders' institution. J Hum Nutr Diet. 2003 Jun;16(3):167-79
    Gesch, B. et al,
Influence of supplementary vitamins, minerals and essential fatty acids on the antisocial behaviour of young adult prisoners: Randomised, placebo-controlled trial
The British Journal of Psychiatry 2002 181: 22-28
    Goodwin, Frederick K and Jamison, Kay Redfield.  Manic-Depressive Illness: Bipolar Disorders and Recurrent Depression, Second Edition.  Oxford University Press.  Mar 2007.
    Hebert LE, Scherr PA, Bienias JL, Bennett DA, Evans DA: Alzheimer disease in the US population. Prevalence estimates using the 2000 census. Arch Neurol 2003, 60:1119–1122.
    Hellhammer, J. et al. Effects of Soy Lecithin Phosphatidic Acid and Phosphatidylserine Complex (PAS) on the Endocrine and Psychological Responses to Mental Stress. Stress. 2004, Vol. 7, No. 2 , Pages 119-126
    Hudson, James et al.  The Prevalence and Correlates of Eating Disorders in the National Comorbidity Survey Replication. Biological Psychiatry 1 February 2007 (Vol. 61, Issue 3, Pages 348-358)
    Jacka, Felice N. et al. Association between magnesium intake and depression and anxiety in community-dwelling adults: the Hordaland Health Study.  Australian and New Zealand Journal of Psychiatry 2009 43:1, 45-52
    Jacka FN, Pasco JA, Mykletun A, Williams LJ, Hodge AM, O'Reilly SL, Nicholson GC, Kotowicz MA, Berk M, Association of Western and traditional diets with depression and anxiety in women. Am J Psychiatry. 2010 Mar;167(3):305-11
    Jacka FN, Pasco JA, Mykletun A, Williams LJ, Nicholson GC, Kotowicz MA, Berk M. Diet quality in bipolar disorder in a population-based sample of women. J Affect Disord. 2011 Mar;129(1-3):332-7
    Jackson, Stanley W.  Melancholia and Depression: From Hippocratic Times to Modern Times.  Yale University Press. 1990
  • 40. REFERENCES - Emily Deans, M.D
    Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005;62: 593–602
    Kim, Young Shin, Leventhal, Bennett L., Koh, Yun-Joo, Fombonne, Eric, Laska, Eugene, Lim, Eun-Chung, Cheon, Keun-Ah, Kim, Soo-Jeong, Kim, Young-Key, Lee, HyunKyung, Song, Dong-Ho, Grinker, Roy Richard. Prevalence of Autism Spectrum Disorders in a Total Population Sample. Am J Psychiatry 2011 0: appi.ajp.2011.10101532
    Le-Niculescu, H. et al. Convergent functional genomics of anxiety disorders: translational identification of genes, biomarkers, pathways and mechanisms. Translational Psychiatry (2011) 1, e9; doi:10.1038/tp.2011.9
    Mulvhill, B. et al. Prevalence of Autism Spectrum Disorders - Autism and Developmental Disabilities Monitoring Network, United States, 2006.  MMMR Suveillance Summaries December 18, 2009 / 58(SS10);1-20
    Okusaga O, Yolken RH, Langenberg P, Lapidus M, Arling TA, Dickerson FB, Scrandis DA, Severance E, Cabassa JA, Balis T, Postolache TT.  Association of seropositivity for influenza and coronaviruses with history of mood disorders and suicide attempts. J Affect Disord. 2011 Apr;130(1-2):220-5
    Pelsser LM, Frankena K, Toorman J, Savelkoul HF, Dubois AE, Pereira RR, Haagen TA, Rommelse NN, Buitelaar JK. Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): a randomised controlled trial.  Lancet. 2011 Feb 5;377(9764):494-503
    Schiff M, Bénit P, Coulibaly A, Loublier S, El-Khoury R, Rustin P. Mitochondrial response to controlled nutrition in health and disease. Nutr Rev. 2011 Feb;69(2):65-7
    Szewczyk B, Kubera M, Nowak G. The role of zinc in neurodegenerative inflammatory pathways in depression. ProgNeuropsychopharmacolBiol Psychiatry. 2011 Apr 29;35(3):693-701
    Urosevic N, Martins RN.  Infection and Alzheimer's disease: the APOE epsilon4 connection and lipid metabolism. J Alzheimers Dis. 2008 May;13(4):421-35
    Yaffe, Kristine Yaffe et al. Mild Cognitive Impairment, Dementia, and Their Subtypes in Oldest Old Women. Arch Neurol. 2011;68(5):631-636.
    Yolken RH, Torrey EF, Lieberman JA, Yang S, Dickerson FB. Serological evidence of exposure to Herpes Simplex Virus type 1 is associated with cognitive deficits in the CATIE schizophrenia sample. Schizophr Res. 2011 May;128(1-3):61-5.
    Zaalberg, A., Nijman, H., Bulten, E., Stroosma, L. and van der Staak, C. (2010), Effects of nutritional supplements on aggression, rule-breaking, and psychopathology among young adult prisoners. Aggressive Behavior, 36: 117–126. doi: 10.1002/ab.20335
    Zeisel, Steven H, and da Costa, Kerry-Ann. Choline: An Essential Nutrient for Public Health.  Nutr Rev. 2009 November; 67(11): 615–623.
  • 41. ResiliencyAn Evolutionary Pathway to Optimal Mental and Physical Health