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 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
 Clever Nutrition can kick out depression
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Clever Nutrition can kick out depression

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  • stress can be a positive force and help increase productivity, but after a certain point it can become detrimental.
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    • 1. NUTRITION- AN INEVITABLE LINK WITH DEPRESSION PRESENTED BY. PUSHPA DHAMI M.SC FOODS AND NUTRITION ANGRAU, Hyderabad
    • 2. Yet to see……. • • • • • • • • • • • • • • • • Introduction Prevalence of depression Symptoms, Causes, Factors, Types of depression Link between Nutrition, Neurotransmitters and Depression Role of amino acids Role of carbohydrates, protein and fat Role of vitamin and minerals Probiotics and depression Alcohol and depression Caffiene and depression Exercise, Sleep and depression Natural herbs and depression Antidepressants and Depression Conclusion Tips to follow References
    • 3. Introduction • The General definition of Depression is a psychological disorder that affects a person's mood changes, physical functions and social interactions. • Depression is a common mental disorder that causes people to experience depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration.
    • 4. Prevalence • The World Health Organization has ranked depression on the 4th place of causes of diseases worldwide. • Until 2020, depression will, together with myocardial infarction, be the main cause of disability (WHO Health Report 2006). • One in seven people (15 per cent) in high-income countries • One in nine (11 per cent) in middle- and low-income countries are likely to get depression over their lifetime. • Prevalence of major depressive disorder has been estimated to be 2% of children and 4-8% of adolescents .
    • 5. • Depression affects over 120 million people worldwide. It can interfere with a person's ability to work, make relationships difficult, and destroy quality of life. • In severe cases it leads to suicide, causing 850,000 deaths a year. • A study based on the World Health Organization‘s World Mental Health Survey Initiative has said that India has the highest rate of major depression (36%) in the world. • The global study, based on interviews with 89,000 people, shows that women are twice as likely to suffer depression as men. • Unemployed tend to have higher rates of depression (almost 13 percent) than those who are employed full time (7 percent).
    • 6. Causes of depression Acc. To (CARMHA) Centre for Applied Research in Mental Health and Addiction (2009)
    • 7. Factors contributes to depression 1. Genetic factors- The genetic risk of developing clinical depression is about 40% if a biological parent has been diagnosed with the illness, with the remaining 60% being due to factors within the individual‘s own environment. 2. Biochemical factors- Three important neurotransmitters that affect a person‘s mood are serotonin, noradrenaline and dopamine. 3. Physical illness- Compromised immune functioning 4. Gender - studies have shown that there is a much greater likelihood of women developing non-melancholic depression than men. 5. Ageing brain 6. Stress Fact sheet( Oct 2012)
    • 8. Types of depression 1. Mild depression • It has a limited negative effect on one‘s daily life. For eg. difficulty concentrating at work or motivating yourself to do the things you normally enjoy. 2. Major depression • Interferes with an individual‘s daily life - with eating, sleeping and other everyday activities. • Some people may experience only one episode but it is more common to experience several episodes in a lifetime. 3. Dysthymic disorder, or dysthymia, • Characterized by long-term (2 years or longer). • Symptoms are not be severe enough to disable a person but can prevent normal functioning or feeling of well being. According to NIMH( National institute of Mental Health)
    • 9. 4. Bi-polar disorder • Bipolar disorder is characterized by cycling mood changes—from extreme highs (e.g., mania) to extreme lows (e.g., depression). 5. Post-natal depression • Many new mothers experience what are sometimes called 'baby blues' a few days after the birth. • Mothers feeling completely overwhelmed, inadequate and unable to cope. • Also experience negative feelings towards their child. It affects one in ten mothers and usually begins two to three weeks after the birth. 6. Seasonal Affective Disorder (SAD) • Sometimes called ‗winter blues‘. SAD can make the sufferer feel anxious, stressed and depressed. It may interfere with their moods and with their sleeping and eating patterns. According to NIMH( National institute of Mental Health)
    • 10. Different Occupations and Depression • Occupations with both high demand and low control over daily tasks are known to cause stress. • Jobs with long hours or shift work, which comes with irregular sleep schedules, can be problematic for people with depression. • Lawyers, Judges, or Police officers, are exposed to the worst human behavior; these negative experiences can alter your perspective on the world and the people may prone to depression. • According to statistics from the 2007 National Survey on Drug Use and Health, the jobs with the lowest rates of depression included engineering, architecture, and the sciences (for both men and women).
    • 11. 2007 (SAMHSA), an agency within the U.S. Department of Health and Human Services. The type of jobs people hold can also influence the likelihood that they will become depressed. Profession Rate of depression (%) • Personal Care and Service 10.8 • Community and Social Services 9.6 • Health Care Practitioners and Technical 9.4 • Education, Training and Library 8.7 • Custodial, Gardening and Maintenance 7.3 • Sales and Related 6.7 • Legal 6.4 • Protective Service 4.8 • Installation, Maintenance and Repair 4.4
    • 12. • Depression is primarily psychological, and best dealt with by counselling. • Depression as a biochemical phenomenon, best dealt with by antidepressant medication. • There is a third aspect to the onset and treatment of depression. Nutrition.
    • 13. Nutrition Nutrition plays a key role in the onset, severity, and duration of depression, including daily mood swings. • Common imbalances connected to nutrition that worsen one‘s mood and motivation: 1. 2. 3. 4. Blood sugar imbalances (often associated with excessive sugar and stimulant intake) Lack of amino acids (tryptophan and tyrosine are precursors of serotonin and noradrenaline) Lack of B vitamins (vitamin B6, folate, B12) Lack of essential fats (omega-3)
    • 14. Neurotransmitters • The most prevalent biochemical theory for the cause of these imbalances is a brain imbalance in two families of neurotransmitters. These are: 1. Serotonin, thought to primarily influence mood 2. Dopamine,noradrenaline,and adrenaline, thought to primarily influence motivation (Primary Care Mental Health (2003),Radcliffe Medical Press)
    • 15. Nutrition, Neurotransmission and Depression Neurotransmission plays a role in mood. Important neurotransmitters (NT's) such as 1. Serotonin (Ser), 2. Dopamine (DA), 3. Norepinephrine (NE), 4. Acetylcholine (Ach), and 5. Glutamate (Glu). •Nutrients required for synthesis of NT's includes •Amino acids (tryptophan, tyrosine, glutamine), •Minerals (zinc, copper, iron, magnesium), a nd •B-vitamins (B6, B12, folic acid).
    • 16. Patrick Holford. (2003) and TS Sathyanarayana Rao et.al, (2008)
    • 17. S-adenosine methionine • SAMe is a methyl donor and is involved in the synthesis of various neurotransmitters in the brain. • Derived from the amino acid L-methionine through a metabolic pathway called the one-carbon cycle, SAMe has been postulated to have antidepressant properties. • Over 100 placebo-controlled, double-blind studies have shown that SAMe (200–1600 mg/d) is equal to or superior to antidepressants, works faster, most often within a few days (most pharmaceutical antidepressants may take three to six weeks to take effect) and with few side effects. • Limitation- Very expensive and very unstable. • An alternative that is much more stable and less costly is tri-methyl-glycine (TMG). David Mischoulon and Maurizio Fava (Am J Clin Nutr 2002)
    • 18. Methyl tetrahydrofolat e reductase Patrick Holford. (2003) and TS Sathyanarayana Rao et.al, (2008) Tri methyl glycine
    • 19. Role of amino Acids
    • 20. Tryptophan- reduces depression • A study was conducted with hypothesis that what would happen if you deprived people of tryptophan. • They gave 15 volunteers who had a history of depression, but were currently not depressed, a nutritionally balanced drink that excluded tryptophan. • Within seven hours, 10 out of 15 noticed a worsening of their mood and started to show signs of depression. • On being given the same drink, but this time with tryptophan added, their mood improved. • Supplementing the amino acid tryptophan is already proven to improve mood.
    • 21. 5-HTP- how it reduces depression • The first study proving the moodboosting power of 5-HTP was done in the 1970s in Japan, under the direction of Professor Isamu Sano of the Osaka University Medical School. • He gave 107 patients 50 to 300 mg of 5-HTP per day, and within two weeks, more than half experienced improvements in their symptoms. • By the end of the fourth week of the study, nearly three-quarters of the patients reported either complete relief or significant improvement, with no side effects. • This study was repeated by Nakajima et al. who also found that 69% of patients improved their mood.
    • 22. Recommended dosage • The recommended dosage of this amino acid, available in any health food shop, is 100mg of 5-HTP, two or three times a day, for depression. • Some supplements also provide various vitamins and minerals such as B12 and folic acid, which may be even more effective because these nutrients help to turn 5-HTP into serotonin.
    • 23. Phenylalanine and depression • In a double-blind study by Helmut Beckmann and colleagues at the University of Wurzburg, Germany, 150 to 200mg of the amino acid phenylalanine, or the antidepressant drug imipramine, were administered to 40 depressed patients for one month. • Both groups had the same degree of positive results less depression, less anxiety and no sleep disturbance. • A group of researchers at the Rush Medical Center, Chicago, USA screened depressed patients by testing phenylethylamine in the blood; low levels meant one needed more phenylalanine. • They then gave 40 depressed patients supplements of phenylalanine, and 31 of them improved.
    • 24. Tyrosine • In a pilot study administering 3200 mg tyrosine a day to 12 patients , a significant improvement in mood and sleep was observed on the very first day. • Twenty-one cadets were put through a demanding oneweek military combat training course. • Ten cadets were given a drink containing 2 g of tyrosine a day, while the remaining 11 were given an identical drink without the tyrosine. • Those on tyrosine consistently performed better, both in memorising the task at hand and in tracking the tasks they had performed.
    • 25. Role of Carbohydrates, protein and Fat
    • 26. Sugars and depression • Since the brain depends on an even supply of glucose. • Excessive consumption of refined sugar is undesirable is that it uses up the body‘s vitamins and minerals. • Every teaspoon of sugar uses up B vitamins for its catabolism, thereby increasing demand. • About 98% of the chromium present in sugarcane is lost in turning it into sugar. This mineral is vital for keeping the blood sugar level stable. • Limit sugary foods and opt for smart carbs, such as whole grains, fruits, vegetables, and legumes, which all contribute healthy carbs as well as fiber.
    • 27. • Wurtman et al. suggest that high-carbohydrate meals increase serotonin synthesis. • Consumption of a meal that is high in carbohydrate, branched chain amino acids and tryptophan has a significant effect because both glucose from the carbohydrate and the branched chain amino acids (particularly leucine) increase insulin secretion. • Insulin facilitates the transport of branched chain amino acids into muscle cells, thereby reducing the competition for tryptophan by the large neutral amino acids. • Further tryptophan transporter protein carries it across the blood–brain barrier. • Drowsiness induced by increased serotonin is the common effect of a large carbohydrate meal.
    • 28. • Obese people prove more likely to suffer from depression. Conversely, depressed people may become inclined to eat carbohydrates as a way of boosting their serotonin to create temporary solace from their depression. • Habitually appeasing depression-triggered carbohydrate cravings in turn increases caloric intake, leading to greater fat production and more weight gain; creating a vicious cycle.
    • 29. Protein and Depression • Depressed people have substantially lower levels of p11 in their brain tissue than the non-depressed. • P11 is a protein in brain which increases serotonin-signaling receptors. • The mice were given two older antidepressants — one known as a tricyclic, the other an MAO(monoamine oxidase) inhibitor. • Each treatment increased the amount of p11 in mice brains, even though each therapy is known to work in different ways. • So the researchers bred mice that had no p11-producing gene. • They acted depressed, and had fewer seotonin receptors and less serotonin activity than regular mice. (Per Svenningsson, 2007)
    • 30. • Blendy, J.A (2006). Protein that could serve as a convergence point for multiple classes of antidepressant drugs is the transcription factor CREB (cyclic adenosine monophosphate response element binding protein). • CREB is upregulated by chronic antidepressant treatment, and increasing CREB levels in rodent models results in antidepressant-like behaviors. • Good sources of healthy proteins: beans and peas, lean beef, low-fat cheese, fish, milk, poultry, soy products, yogurt.
    • 31. High-Fat Diet Linked to Depression • The research team fed mice already prone to obesity different kinds of food and monitored how the diet affects the way the animals behave. • Mice that have been fed a higher-fat diet exhibit signs of being anxious, such as an avoidance of open areas, and of being depressed, such as making less of an effort to escape when trapped. • These mice have higher levels of corticosterone, a hormone that is associated with stress. ScienceDaily (May 23, 2012)
    • 32. Omega 3 fatty acids • Omega-3 fats are effective for severe depression. • A recent trial published in the American Journal of Psychiatry tested the effects of giving omega 3 FA to 20 people suffering from depression (who were already on antidepressants but still depressed). • A highly concentrated form of omega-3 fat, ethyl-EPA, was given versus a placebo. • By the third week, the depressed patients were showing major improvement in their mood, while those on placebo were not.
    • 33. • Taking a daily supplement of 1 g of omega-3 fatty acids has been found to significantly reduce several of the symptoms associated with depression, including- insomnia, anxiety, prolonged experiences of sadness, and suicidal impulses. • Studies have shown that individuals suffering with depression have seen their symptoms diminish as much as 50%. Foods that have high levels of omega 3 include: Salmon Tuna Dark leafy green vegetables Flaxseed Salted mackerel Walnuts Canola oil Fresh basil • • • • • • • •
    • 34. Role of vitamin and minerals
    • 35. Vitamin B1 (thiamine) • The brain uses this vitamin to help convert glucose, or blood sugar, into fuel, and without it the brain rapidly runs out of energy. • This can lead to fatigue, depression, irritabilit y, anxiety, and even thoughts of suicide. • The consumption of refined carbohydrates, such as simple sugars, drains the body's B1 supply. Vitamin B3 (niacin) • Pellagra- which produces psychosis and dementia, among other symptoms-is eventually found to be caused by niacin deficiency. • Subclinical deficiencies of vitamin B3 can produce agitation and anxiety, as well as mental and physical slowness.
    • 36. Vitamin B5 (pantothenic acid) • Vitamin B5 is needed for hormone formation and the uptake of amino acids and the brain chemical acetylcholine, which combine to prevent certain types of depression. • Symptoms of deficiency are fatigue, chronic stress, and depression. Vitamin B6 (pyridoxine) • It is needed in the manufacture of serotonin, melatonin and dopamine. • Vitamin B6 deficiencies, although very rare, cause impaired immunity, skin lesions, and mental confusion. • A marginal deficiency sometimes occurs in alcoholics, patients with kidney failure, and women using oral contraceptives.
    • 37. Vitamin B12 Vitamin B9 (Folic acid) • This B vitamin is needed for DNA synthesis. • It is also necessary for the production of SAMe (S-adenosyl methionine. • It is usually administered along with vitamin B12, since a B12 deficiency can mask a folic acid deficiency. • Pregnant women are often advised to take this vitamin to prevent neural tube defects in the developing fetus. • • B12 may help to fight depression by inhibiting monoamine oxidase (MAO), an enzyme that metabolizes some of the neurotransmitters that help to elevate mood. In that sense, B12 works like the monoamine oxidase inhibitors (MAOI), drugs prescribed for depression. • When shortages do occur, they are often due to a lack of intrinsic factor, an enzyme that allows vitamin B12 to be absorbed in the intestinal tract. Since intrinsic factor diminishes with age, older people are more prone to B12 deficiencies. • Can cause mood swings, irritability, confusion, dementia, h allucinations, or mania.
    • 38. B Vitamins Vitamin B1 (thiamine) Vitamin B2 (Riboflavin) Vitamin B3 (niacin) Vitamin B5 (pantothenic acid) Sources Recommendation Brown rice, egg yolk's, fish, wheat germ, and whole grains. 1mg to 1.5mg, maximum amount for adults, 300mg. Meats, eggs and dairy, as well as in green vegetables and legumes. 1.1 to 1.3 mg per day for adult. Maximum amount for adults, 200mg. Lean meat, peanuts, wheat germ, fish, poultry. 18mg for men daily, 13mg for women daily, maximum amount for adults is 100 to 3,000mg. Bran, peanuts, brewers yeast, avocados, beef, eggs, fresh vegetables, and whole wheat. 2.2mg a day, maximum dosage, is 100mg to 1,000mg a day for adults.
    • 39. B Vitamins Sources Recommendation Vitamin B6 (pyridoxine) Meats, fish, peanuts, 2.2mg per day for an adult, soybeans, bananas, whole maximum dosage is 100 to grains, spinach and broccoli. 1000mg per day for an adult. Vitamin B12 Meat, clams, eggs, milk, and 6mcg daily, maximum adult dosage is 1mg. dairy products. Folic acid Green leafy vegetables, 400mcg a day for adults, wheat germ, dried beans and maximum dosage is 800 to peas. 3,000mcg per day for adults
    • 40. Vitamin C • The link between vitamin C deficiency and depression may be caused by lower neurotransmitter levels. • According to an August 2003 article in "Nutrition Journal," vitamin C works together with the enzyme dopamine-beta-hydroxylase to convert dopamine into norepinephrine, which plays an important role in the regulation of mood. • Symptoms of vitamin C deficiency include fatigue and depression. • Found in- citrus fruit, strawberries, tomatoes, peppers and broccoli. • Recommended dosages- Consume between 75 and 90 mg of vitamin C each day.
    • 41. Vitamin D • Researchers note that people suffering from depression, particularly those with seasonal affective disorder, tend to have reduced vitamin D levels in the body. • There are receptors for parathyroid hormone (PTH) and 1,25– dihydroxyvitamin D in the brain, and there are clinical and experimental data indicating that PTH and vitamin D may affect cerebral function. • The authors also have concluded that there ―appears to be a relation between serum levels of 25-(OH) D and symptoms of depression. • Supplementation with high doses of vitamin D(400 IU to 800 IU of vitamin D, ) seems to ameliorate these symptoms indicating a possible causal relationship.‖
    • 42. • In a study published in Clinical Rheumatology in 2007, researchers found that there might be a correlation between vitamin D deficiency and depressive symptoms if associated with other illnesses. • For example, if someone has rheumatoid arthritis and vitamin D deficiency, they are more likely to suffer depression. • The Institute of Medicine recently raised the recommended daily intake to 600 IU for people aged 1-70 and to 800 IU for adults older than 70.
    • 43. Minerals Magnesium • Deficiency can result in depressive symptoms, along with confusion, agitation, anxiety, and hallucinations, as well as a variety of physical problems. Calcium • Depletion affects the central nervous system. Low levels of calcium cause nervousness, apprehension, irritability, and numbness. They work best when taken together. • Dosage: Take a calcium and magnesium combination formula that supplies 500 milligrams of calcium and 250 to 500 milligrams of magnesium twice daily.
    • 44. Zinc: • Inadequacies result in apathy, lack of appetite, and lethargy. • When zinc is low, copper in the body can increase to toxic levels, resulting in paranoia and fearfulness. Dosage: 30-40 mg daily (as picolinate) Selenium• Selenium is an antioxidant. It has a mood-elevating effect.100-200 mcg daily. Iron: • Depression is often a symptom of chronic iron deficiency. • It include general weakness, listlessness, exhaustion, lack of appetite, and headaches. 10-30 mg daily.
    • 45. Manganese: • Since it also plays a role in amino-acid formation, a deficiency may contribute to depression stemming from low levels of the neurotransmitters serotonin and norepinephrine. • Manganese also helps stabilize blood sugar and prevent hypoglycemic mood swings. • Dosage- 2-10 mg daily Potassium • Depletion is frequently associated depression, tearfulness, weakness, and fatigue. Dosage- 1800-5625mg daily Chromium • Helps keep blood-sugar levels in balance. • Dosage: 200 micrograms daily. with
    • 46. Additives In the 1950s , 20% of our food items were controlled by the supermarkets, now the figure is about 80%. • 3,500 chemicals are used as food additives in the manufacture of convenience foods and drinks. • 75% of the Western diet is made up of various processed foods, each person is now consuming an average 8-10 lbs of food additives per year, • Some additives are of particular concern because of their potential effects on mental health.
    • 47. Additive Aspartame Known as/ ADI E951 (40mg/kg B.W) Used in Reasons to avoid Diet coke, desserts, sugar free gum, drink mixes, table top sweeteners, cereal, breathmints, puddings, toothpaste, cough syrup Aspartame is a neurotoxin and carcinogen.erode intelligence and affect short-term memory , Parkinson's, Alzheimer's, headaches, nausea, mental confusion High Fructose Corn Syrup HFCS Most processed foods, breads, candy, salad dressings, canned vegetables, cereals Increases your LDL (―bad‖) cholesterol levels, and contributes to the development of obesity and diabetes. Monosodium Glutamate MSG / E621 Chinese food, potato chips, many snacks, chips, cookies, lunch meats Effects the neurological pathways of the brain. MSG is an excito-toxin, and regular consumption may result in depression, disorientation, eye damage, fatigue, headaches, and obesity. (10mg/kg B.W)
    • 48. Additive Known as Used in BHA and BHT E320 (0.5 mg/kg B.W/day) Used as a preservative in Effects the neurological system potato chips, gum, of the brain, alters behavior and cereal,, enriched rice, has potential to cause cancer.. lard, shortening, candy Food Dyes Blue #1 & Blue #2 Red #3 & Red #40 Yellow #6 & Yellow Tartrazine Sodium Sulphite E133 E124 E110 E102 (0-7.5mg/kg B.W/ day) E221 Reasons to avoid Fruit cocktail, ice cream, Artificial colorings, may candy, bakery products, contribute to behavioral macaroni and cheese problems like ADD and ADHD in children and lead to a significant reduction in IQ. Wine and dried fruit According to the FDA, approximately one in 100 people are sensitive to sulphites in food. Individuals who are sulfite sensitive may experience asthma, headaches, breathing problems and rashes.
    • 49. Probiotics and depression • Stress, a significant factor in MDD, is known to alter GI microflora, lowering levels of lactobacilli and bifidobacterium. • Research suggests that bacteria in the GI tract can communicate with the central nervous system, even in the absence of an immune response. • The effect of probiotics on systemic inflammatory cytokines and oxidative stress may ultimately lead to increased brain derived neurotrophic factor (BDNF). Logan, A. C. and M. Katzman (2005).
    • 50. • The study, led by A. Venket Rao and co-authored by Dr. Alison C. Bested, administered 39 CFS patients either three doses of Lactobacillus casei a day, or a placebo, for two months. • They found that 73 per cent of subjects taking the probiotic experienced an increase in levels of Lactobacillus and Bifidobacteria in the gut, which corresponded with a significant decrease in anxiety symptoms. • In the placebo group, only 37.5 per cent showed an increase in Bifidobacteria, while only 43.8 per cent showed an increase in Lactobacillus bacteria. • Mice fed a broth containing Lactobacillus rhamnosus. It was discovered that these rodents displayed significantly less behavior linked with stress, anxiety and depression than mice fed plain broth.(Charles Q. Choi , 2011)
    • 51. The Mediterranean Diet • Numerous studies have proven the beneficial effects of the Mediterranean diet on a wide range of health issues including anxiety and depression. • It includes large amounts of fish, olive oil, fruits and nuts, cereals, dark green vegetables and legumes. • Because of this diet‘s high levels of essential nutrients, minerals and vitamins is considered by some to be the optimal diet for proper brain health and overall health in general. • Studies have shown that in addition to reducing the risk of depression by up to 30% the Mediterranean diet is also effective against heart disease and other health issues related to inflammation.
    • 52. Alcohol and depression • Causal linkage between alcohol use disorders and major depression, such that increasing involvement with alcohol increases risk of depression. (Joseph M. Boden et.al, 2011) • Depression is primarily related to drinking larger quantities per occasion, less related to volume, and unrelated to drinking frequency, and this effect is stronger for women than for men. • Former drinkers had slightly higher rates of major depression and higher scores on depressed affect compared with light drinkers. ( Kathryn Graham et.al, 2006)
    • 53. Caffeine and depression • Depression risk decreases with increasing caffeinated coffee consumption. (Michel Lucas et.al, 2011) • Caffeine sparks up neurotransmitters, serotonin and dopamine and makes them come alive. • Many find that when they drink coffee they become more alert and able to concentrate. Dark side • Caffeine dehydrate the person since it is a diuretic. • It depletes the body of the Vitamin B6. Those who have low Vitamin B6 levels are more likely to suffer from anxiety or depression.
    • 54. Exercise and depression • For mild to moderate depression, aerobic exercise is usually a key component to a treatment plan. ( Birmaher B. et.al, 2007) • A 2005 study at the University of Texas Southwest Medical Center was the first study to look at exercise alone in treating mild to moderate depression in adults aged 20-45. • It showed that depressive symptoms were reduced almost 50 percent in individuals who participated in 30minute aerobic exercise sessions three to five times a week. • In addition, exercise stimulates the neurotransmitter norepinephrine, which may directly improve a person‘s mood.
    • 55. Sleep and Depression • For optimal physical and mental health, most people need about 6-9 hours of sleep per day, at regular times. But many people have difficulties with sleep. • More than 80% of those suffering from depression experience insomnia or some type of sleep disturbance which increase a person‘s risk of developing depression or experiencing a recurrence of depression. • The psychological symptoms of sleep deprivation include: mood swings, irritability, impatience, anxiety, depression, fatigue, de creased alertness and concentration, impaired memory, and impaired judgment. (Masley, J. et.al.2005).
    • 56. Herbs and Depression 1. Ginkgo biloba• Ginkgo leaves contain flavonoids and terpenoids, which are powerful antioxidants. Laboratory studies have shown that ―GBE improves blood circulation by dilating blood vessels and reducing the stickiness of blood platelets.‖ 2. Rhodiola Rosea (Golden Root)• Its ability to stimulate production of brain neurotransmitters such as endorphins and serotonin. 3. St John’s wort• It is suggested that up to 900 mg of St John‘s wort per day is required to effectively reduce symptoms of non-melancholic depression .(Lawvere, S. and Mahoney, M. (2005)
    • 57. Antidepressant drugs • Selective serotonin reuptake inhibitors (SSRIs) Block the reuptake of serotonin from the synapse to the nerve, which increases levels of serotonin. Fluoxetine (20 mg), sertraline (50 mg), paroxetine (20 mg) etc. • Serotonin and norepinephrine reuptake inhibitors (SNRIs) SNRIs include venlafaxine (75 mg ) and duloxetine (40-60 mg). • Bupropion (150 mg)- It acts by blocking the reuptake of dopamine and norepinephrine and increases these neurotransmitters in the brain.
    • 58. Antidepressant Drugs • Mirtazapine (15-45 mg/ day) Mirtazapine targets specific serotonin and norepinephrine receptors in the brain, thus indirectly increasing the activity of several brain circuits. • Atypical antipsychotics. Aripiprazole (Abilify) and quetiapine (Seroquel) are atypical antipsychotics that were approved by the FDA in 2007, and used to augment depression when used along with antidepressants. • Tricyclic antidepressants (TCAs) TCAs include amitriptyline (150 mg), desipramine (150-200 mg/day), doxepin (150 mg), imipramine (50-200 mg/day)
    • 59. Side effects of Antidepressants • • • • • • • • • Nausea Weight gain Fatigue Restlessness Insomnia Headache Sexual side effects Tremor Dry mouth • • • • • • • Agitation Rapid heartbeat Dizziness Constipation Menstrual complaints Skin rash Gastrointestinal problems.
    • 60. Summary
    • 61. Take home Message
    • 62. Tips to follow 1.Eating a healthy and balanced diet is among the best diet tips for depression. Eating three to four evenly spaced meals throughout the day prevents a sudden rise or fall in blood sugar levels, which in turn prevents depression. 2.Along with other diets tips for depression, do not forget to consume adequate amounts of water as good hydration combats fatigue and stress. 3. A natural diet tip for depression is to augment B vitamins in the diet, especially vitamin, B12 found in fish, meat, poultry, eggs, and milk, and folic acid present in mushrooms, lentils, and legumes. 4. One of the must follow diet tips for depression and anxiety is to opt for smart carbs like whole grains, fruits, legumes, and vegetables rather than refined sugars to stabilize the mood by keeping blood glucose levels steady. •
    • 63. Tips to follow 5. There is a relationship between obesity and depression. Maintaining a healthy weight is important for someone with depression. 6. Consuming natural proteins like beans, peas, low-fat cheese, fish, milk, soy products, and yogurt is another diet tip for combating depression. 7. Selenium rich products like nuts (brazil nuts), seeds, sea food, lean meat, beans, and legumes should be included in a diet for depression. 8. Eating foods rich in antioxidants and vitamins E and C prevents depression. 9. Consume plenty of vitamin D by getting adequate exposure to sunlight to boost your mood. 10.Watch the amount for stimulants like coffee, tea, alcohol.
    • 64. References • Bourre, J. M. (2005). "Dietary omega-3 Fatty acids and psychiatry: mood, behaviour, stress, depression, dementia and aging." J Nutr Health Aging 9(1): 31-8. • Coppen, A. and C. Bolander-Gouaille (2005). "Treatment of depression: time to consider folic acid and vitamin B12." J Psychopharmacol 19(1): 5965. • • David Mischoulon and Maurizio Fava, (2002). “Role of S-adenosyl-Lmethionine in the treatment of depression.” Am J Clin Nutr;76(suppl):1158S– 61S Dianne Volker and Jade N.G. (2006). ―Depression: Does nutrition have an adjunctive treatment role.‖ Nutrition & Dietetics(63): 213–226 DOI: • Hvas, A. M., S. Juul, et al. (2004). "Vitamin B6 level is associated with symptoms of depression."Psychother Psychosom 73(6): 340-3. • John I. Nurnberger, (2002). ―Is There a Genetic Relationship Between Alcoholism and Depression‖. Alcohol research and health. Vol. 26, No. 3, • Joseph M. Boden and David M. Fergusson .(2011 ). Alcohol and depression Society for the Study of Addiction
    • 65. References References • Link Between Fast Food and Depression . ScienceDaily (Mar. 30, 2012) • Logan, A. C. (2004). "Omega-3 fatty acids and major depression: a primer for the mental health professional." Lipids Health Dis 3: 25. • Logan, A. C. and M. Katzman (2005). "Major depressive disorder: probiotics may be an adjuvant therapy.― Med Hypotheses 64(3): 533-8. • Patrick Holford, (2003) .Depression: the nutrition connection, Primary Care Mental Health 1: 9- 16 • Practice Guideline for the Treatment of Patients With Major Depressive Disorder, Third Edition, (October 2010). • Rena Freedenberg, N. D. (2009). ―Naturopathic/Holistic Treatment of Mild to Moderate Depression.‖ Natural Medicine Journal 1(4). • Sachdev, P. S., R. A. Parslow, et al. (2005). "Relationship of homocysteine, folic acid and vitamin B12 with depression in a middle-aged community sample." Psychol Med 35(4): 529-38. • Sathyanarayana Rao T. S, Asha M. R, Ramesh B. N, Jagannatha Rao K.S. ―Understanding nutrition, depression and mental illnesses.‖ Indian J Psychiatry 2008;50:77-82

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