Until recently nutrition and various other lifestyle factors were predominantly in the focus of medical disciplines like cardiology, endocrinology or gastroenterology. As mental disorders are multifactorial diseases and as such are complex, emerging evidence suggests that nutrition, exercise and sleep also play an important role in the aetiology, progression and treatment of mental disorders.
Incorporating Food Addiction into Disordered Eating: The Food and Weight Unit...Nutrition in Recovery
Registered Dietitian Nutritionist David Wiss is an expert at food addiction. He has noticed that the classic eating disorder algorithm has been unsuccessful in integrating the latest research on food addiction into eating disorder treatment. In this presentation Mr. Wiss will review the literature and propose a model for incorporating food addiction into disordered eating. A new model will be proposed.
"Nutrition Interventions Amidst an Opioid Crisis: The Emerging Role of the RD...Nutrition in Recovery
This presentation was given at the Food and Nutrition Conference and Expo (FNCE) on Sunday October 21, 2018 in Chicago. Here David Wiss MS RDN describes the impact of opioids on nutritional status and gastrointestinal health, identifies common disordered and dysfunctional eating patterns common to opioid-addicted populations, and describes nutrition therapy protocols for specific substances including opioids and for poly-substance abuse.
David Wiss MS RDN walks you through research on childhood adversity and the various ways that trauma can become embedded into physiology and impact health, such as eating behavior.
Novel Condition Monograph for Complimentary Alternative Medicine (CAM) modalities proposed for the treatment of Attention Deficit Hyperactivity Disorder (ADHD). Monograph created from a current literature search on treatment for ADHD, evidenced based complimentary therapies, nutrition, and dietary interventions.
Incorporating Food Addiction into Disordered Eating: The Food and Weight Unit...Nutrition in Recovery
Registered Dietitian Nutritionist David Wiss is an expert at food addiction. He has noticed that the classic eating disorder algorithm has been unsuccessful in integrating the latest research on food addiction into eating disorder treatment. In this presentation Mr. Wiss will review the literature and propose a model for incorporating food addiction into disordered eating. A new model will be proposed.
"Nutrition Interventions Amidst an Opioid Crisis: The Emerging Role of the RD...Nutrition in Recovery
This presentation was given at the Food and Nutrition Conference and Expo (FNCE) on Sunday October 21, 2018 in Chicago. Here David Wiss MS RDN describes the impact of opioids on nutritional status and gastrointestinal health, identifies common disordered and dysfunctional eating patterns common to opioid-addicted populations, and describes nutrition therapy protocols for specific substances including opioids and for poly-substance abuse.
David Wiss MS RDN walks you through research on childhood adversity and the various ways that trauma can become embedded into physiology and impact health, such as eating behavior.
Novel Condition Monograph for Complimentary Alternative Medicine (CAM) modalities proposed for the treatment of Attention Deficit Hyperactivity Disorder (ADHD). Monograph created from a current literature search on treatment for ADHD, evidenced based complimentary therapies, nutrition, and dietary interventions.
The role of diet in managing immune dysfunction and inflammatory processes that contribute to ADHD and related neurodevelopmental disorders
ADHD is a neurodevelopmental disorder characterised by lack of attention, impulsiveness, and hyperactivity. Its cause is considered to be multifactorial, involving a combination of genetics, perinatal factors (e.g., low birth weight, prematurity, prenatal exposure to toxins such as alcohol and/or smoke), as well as environmental and socioeconomic factors.
The immune system is a key player in gut–brain interactions, with extensive alterations in immune function known to contribute to the pathophysiology of neurodevelopmental disorders, including dysregulated inflammation, elevated levels of pro-inflammatory cytokines and altered immune cell function. In this webinar Dr Nina Bailey will describe the role of immune dysfunction and inflammatory processes linked to the pathophysiology of neurodevelopmental disorders and will provide an overview of the nutritional interventions that can help to successfully manage symptoms.
1. What is Stress?
2. Mechanism
Neuro-Anatomy of Stress
Neuro-Endocrine of Stress
Inflammation and Stress
3. Stress and Disease
Stress and Food Addiction
4. Stress and Central Regulation of Metabolism
The role of diet in managing immune dysfunction and inflammatory processes that contribute to ADHD and related neurodevelopmental disorders
ADHD is a neurodevelopmental disorder characterised by lack of attention, impulsiveness, and hyperactivity. Its cause is considered to be multifactorial, involving a combination of genetics, perinatal factors (e.g., low birth weight, prematurity, prenatal exposure to toxins such as alcohol and/or smoke), as well as environmental and socioeconomic factors.
The immune system is a key player in gut–brain interactions, with extensive alterations in immune function known to contribute to the pathophysiology of neurodevelopmental disorders, including dysregulated inflammation, elevated levels of pro-inflammatory cytokines and altered immune cell function. In this webinar Dr Nina Bailey will describe the role of immune dysfunction and inflammatory processes linked to the pathophysiology of neurodevelopmental disorders and will provide an overview of the nutritional interventions that can help to successfully manage symptoms.
1. What is Stress?
2. Mechanism
Neuro-Anatomy of Stress
Neuro-Endocrine of Stress
Inflammation and Stress
3. Stress and Disease
Stress and Food Addiction
4. Stress and Central Regulation of Metabolism
Dietary guidelines are accused to be the key reason for obesity and diabetes epidemic. This slide deck shows why they are not. Junk food diet is the key reason.
Nutrition is a key factor in the onset and progression of cognitive decline, yet despite a growing pool of research, little evidence exists to support the efficacy of single nutrients in this complex area. The most promising evidence comes from specific dietary patterns and nutrients in the prevention and slowed progression of neurodegenerative disease. During this webinar, Dr Bailey will focus on the synergistic role of key nutrients involved in the mechanisms that drive cognitive decline and support healthy brain aging. Topics include:
- Risk factors for cognitive decline
- Biological mechanisms underpinning cognitive decline
Dietary patterns that offer protection and support against cognitive decline
- The role of specific nutrients in protecting brain health and function
- Nutritional recommendations for healthy brain ageing
1ANNOTATED BIBLIOGRAPHY FOR SEDENTARY LIFESTYLESTHESE ARE.docxhyacinthshackley2629
1
ANNOTATED BIBLIOGRAPHY FOR SEDENTARY LIFESTYLES
THESE ARE THE INSTRUCTORS REMARKS AFTER GRADING AND GIVING ME A ZERO/100. PLEASE CORRECT THIS DOCUMENT FOR ME. THANKS.
I HAVE ALSO ATTACHED A Turnitin Report in pdf format.
Hi, Jude. Your Turnitin report showed that 74% of your draft matches sources that were not cited properly. Please review the plagiarism tutorial in the syllabus, and review the APA materials on how to cite sources. Paraphrase your sources whenever possible; this shows you understand the material and can restate it in your own words. This also enables you to claim ownership of the language while still giving credit for the ideas. When you use source material verbatim, make sure to place it in quotation marks. Avoid copying and pasting large chunks of text. Even if you include proper citations, your essay will lack originality. Please review the attached Turnitin report so you can see which sections need attention. I will review your draft and update your score once you've rewritten it in your own words and cited sources properly. Please note the late policy in the syllabus. Let me know if you have any questions. Thanks.
Annotated Bibliography for Sedentary Lifestyles
Jude Kum
DeVry University
Sedentary lifestyle is predominant in our everyday life be it in workplace, school, social or homes and the fact is we have got accustomed to sitting down and doing many things forgetting the impact this is causing to our health. People fail to realize how valuable exercise is in their life and especially in improving their health and well-being. Sitting down on the computer with all focused attention and forgetting that we need to get up and even eat cause problems to many people.
Guedes, N.G., Lopes, M.V., Leite de Araujo, T. Moreira, R.P. and Martins, L.C. G. (2010). Predictive Factors of the Nursing Diagnosis Sedentary Lifestyle in People with High Blood Pressure. Public Health Nursing. Vol. 28 No. 2, p. 193-200. Wiley Periodicals, Inc.
The research question for the study conducted by Guesdes, et al (2010) is based on the following: 1.what is the result of the defining characteristics and related factors of sedentary lifestyle diagnosis in patients with high blood pressure? 2. What are the predictive value and possible predictors of the nursing diagnosis sedentary lifestyle in patients with high blood pressure? The study looked at the validation of diagnostic groupings of the population being studied including aspects of their clinical situations. The study looked at diagnosis resulting from insufficient physical activity, intolerance of activity, fatigue, impaired physical mobility, self-care deficit.
My assessment: Using this article, I will bring out the important indicators and useful predictors for identification of sedentary lifestyle; demonstrated the benefits of physical fitness, verbalized preferences for activities that are to accomplish real training or exercises. I will point out appr.
Nutrition in Recovery: The Role of the Dietitian in Addiction Treatment 2015Nutrition in Recovery
David Wiss MS RDN discusses the importance of nutrition in addiction recovery and the rationale for the Registered Dietitian Nutritionist to be a member of the treatment team. Topics include:
Food and Mood
Food Addiction
Disordered Eating
Hormones
Nutrition Therapy
iCAAD Paris 2019 - Stuart Fenton - LGBT, the Courageous Communitiy: from stig...iCAADEvents
Stu Fenton will address the many specificities of the LGBT communities and individualities through a multifaceted approach linking identity quest, painful stigmas of Chemsex and addiction, and most importantly the courage and mindfulness of a community facing its challenges with hope and determination. We have so much to learn here.
Could it well be that a Minority is actually leading the Majority by example of self-discovery and self-introspection? As Stu Fenton & al. proposed in Berlin in 2018: “Surely gay culture is not just something depressing? It’s also about self-discovery, adventure, relating to a group of peers, have meaningful relations, reaching out to others in order to lift each other up and having all sorts of primal instincts satisfied.”
iCAAD Paris 2019 - Dr Colleen Kelly - Addiction and families - the solution i...iCAADEvents
How does the alcoholic or addicted individual effect the family and community? In what way do they equally become sick? What does intervention, treatment and aftercare look like for the family and how does this effect the individual with addiction?
This masterclass will examine the origins of addiction throughout a family’s history and find new ways to transform those old stories of shame and blame to survival and resilience. Participants will be provided a number of key points aimed at enhancing professional knowledge and performance. We will examine alternative ways to think beyond individual treatment, which include the entire family not only though current Family Therapy models, but by examining the stories and pain of past generations. This cutting-edge thinking regarding family work can transform the lives of generations yet to come who may escape the prison of addiction due to our ability to stand with our clients in their multigenerational story of trauma and adaptation. In conclusion, participants will examine how family therapy techniques including examining generations of Transgenerational Grief provide an opportunity for feelings that have been previously denied and lost in the family story can be named, explored, reframed and viewed as strength and hope.
iCAAD Paris 2019 - Chris John - Understanding the impact of transgenerational...iCAADEvents
This presentation will explain what transgenerational trauma is and highlight how parent-to-child carried emotional dynamics impact the child development and lead to mental health issues and addiction in adulthood. 64% of addicts had severe adverse childhood experience, abuse and trauma. Using the Adverse Childhood Experience Study (ACE) and its findings, participant will be presented with assessment and intervention tools directly applicable to their clinical and psychosocial work and practice. “It’s never too late to have a happy childhood”.
iCAAD London 2019 - Dr Alberto Pertusa - Addiction treatment: What new medica...iCAADEvents
In this presentation, Consultant Psychiatrist and international addictions specialist, Dr McPhillips, will provide an overview of emerging medical treatments for addiction and Dr Pertusa will discuss ADHD & addiction.
iCAAD London - Elizabeth Hampson and Kay Forsythe - THRIVING AT WORK, THE CAS...iCAADEvents
Deloitte believes that there is an unarguable business case for supporting individuals with mental health challenges, and creating mentally healthy working conditions. This case is not simply a financial one, although the costs of poor mental health are significant. Creating the right conditions for all colleagues to thrive has significant human and societal impact.
iCAAD London 2019 - Dr John Goldin - WORKING WITH THE MEDIA TO PROMOTE CHILD ...iCAADEvents
In this talk Dr Jon Goldin will discuss his experience of working with the media, illustrate this with examples, and offer advice and guidance for those who might undertake this kind of work.
iCAAD London 2019. Monday 6th May. Mark Drax - WE REPEAT WHAT WE DON'T REPAIR...iCAADEvents
We are only as sick as our secrets! An oft-used recovery phrase; but what does it actually mean? Any sort of trauma or abuse experienced in childhood can lead to us keeping secrets. We believe that what happened to us was our fault and we keep it hidden away.
iCAAD London 2019 - Dr Stefanie Carnes - COMPLEX TRAUMA IN WOMEN WITH COMPULS...iCAADEvents
Complex Trauma in Women with Compulsive and Addictive Sexual Behaviour Often compulsive and addictive behaviour is thought of as a male problem, however, more and more women are coming forward struggling with the behaviour.
iCAAD London 2019 - Dufflyn Lammers - RESILIENCE GAMESiCAADEvents
RESILIENCE GAMES is an experiential workshop that creates an empowering journey guiding participants through the discovery of all four types of resilience
iCAAD London 2019 - Stefanie Carnes - SEXUALLY COMPULSIVE AND ADDICTIVE BEHA...iCAADEvents
In recent years there has been tremendous controversy about sexually compulsive behaviour. Researchers and clinicians alike have argued about the best terminology to use, diagnostic criteria, and treatment approaches. In this presentation, Dr. Carnes discusses the concerns about labelling out control sexual behaviour and examines the new research and the controversy surrounding the diagnosis. Different perspectives on conceptualisation of the disorder and treatment will be discussed.
iCAAD London 2019 - Mel Pohl - CHRONIC PAIN AND ADDICTION: HOW WE MISSED THE...iCAADEvents
Chronic Pain occurs as a complicated web of emotions and physical symptoms. The most common way to treat pain is to use opioid medications, which actually complicate the course of chronic pain.
iCAAD London 2019 - Dr Michael McCann and Sarah Chilton - ADDICTION IN THE W...iCAADEvents
In this presentation, participants will learn the impact of addiction on an organisation and the implications for senior executives to develop a comprehensive Alcohol and Drug policy and Management Programme within a corporate setting.
London iCAAD 2019 - Daniel Souery - A TRANSDIAGNOSTIC APPROACH FOR PSYCHIATRI...iCAADEvents
Diagnostic approaches applied in psychiatry are often criticized and deemed unsatisfactory because of their relative lack of reliability and validity. One reason for this complexity lies in the purely symptomatic approach to diagnosis. This approach also results in misdiagnosis, difficulties and high risk of aberrant therapeutic choices. The problem is also the source of great difficulty in differentiating the normal from the pathological in situations of emotional and psychological distress that should not be the subject of a psychiatric diagnosis.
iCAAD London 2019 - Sheri Laine - MAINTAINING EQUILIBRIUM IN THE HERE AND NO...iCAADEvents
Designed for professionals working in Behavioural Mental and Emotional Health, this workshop will pinpoint mind-body techniques including, Meditation, Mindfulness, Acupuncture, Nutrition and Exercise.
London iCAAD 2019 - Nick Barton and Kirby Gregory - THE HEALTHY CONTAINERiCAADEvents
The combination presentation/workshop will examine the concepts of containment and holding environments and explore how they might apply to addiction treatment in terms of their implications for practice, service delivery and organisational development.
iCAAD London 2019 - Clarinda Cuppage and Lou Lebentz - NUMBING THE PAIN: CHI...iCAADEvents
Childhood sexual abuse (CSA) has seemed at the forefront of many news items recently and increasingly out there in the public domain. The statistics quoted in the UK are 1 in 4 women and 1 in 6 men are survivors, higher in other countries such as the USA. Indeed, most of our addiction clients tend to present with underlying trauma, many as a result of CSA. So as clinicians and treatment providers how do we deal with this epidemic in terms of numbers and the resultant increased disclosures and presentations?
iCAAD London 2019 - Chip Somers - REHAB – DEAD OR ALIVE?iCAADEvents
In this presentation Chip will talk about the parlous state of rehab. How it is possible that we have gotten to the point where we have all these rehabs but you can only really get in to them if you have money? How have we let local councils take over the medical care of addicts and alcoholics? How have we tolerated a system so clearly broken to continue?
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
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iCAAD London 2019 - Prof Wulf Rossler - NUTRITION, SLEEP AND PHYSICAL EXERCISE: IMPACT ON MENTAL HEALTH
1. Nutrition, Sleep, Physical
Exercise: Impact on Mental
Health
Wulf Rössler
Berlin | Zürich | São Paulo
ICAAD, London, May 6, 2019
On behalf of “The Kusnacht Practice“
2. Member of the board of Directors of
„The Kusnacht Practice“
3. The role of diet and nutrition on
mental health and wellbeing
Mental, neurological and substance-use disorders presently
represent the greatest global burden of disease
Likewise, depression and other psychopathologies are elevated risk
comorbidities of other health hazards, such as obesity
Nutrition has been implicated in behaviour, mood and in the
pathology and treatment of mental illness.
There is compelling support for nutrition as a modifiable risk factor.
Owen L, Corfe B. The role of diet and nutrition on mental health and wellbeing. Proc
Nutr Soc. 2017 Nov;76(4):425-426
4. Nutrition and Mental Health
Background:
In recent years psychopharmacology achieved only mixed
results in treatment of mental disorders
non-pharmacological treatment approaches receive increasing
attention
extensive epidemiological evidence for associations between
habitual diet quality and mental disorders
Kirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, Johnson BT. Initial
severity and antidepressant benefits: a meta-analysis of data submitted to the Food and
Drug Administration. PLoS Med. 2008 Feb;5(2)
5. Nutritional medicine as mainstream
in psychiatry
Sarris J, Logan AC, Akbaraly TN, Amminger GP, Balanzá-Martínez V, Freeman MP,
Hibbeln J, Matsuoka Y, Mischoulon D, Mizoue T, Nanri A, Nishi D, Ramsey D,Rucklidge
JJ, Sanchez-Villegas A, Scholey A, Su KP, Jacka FN; International Society for Nutritional
Psychiatry Research. Lancet Psychiatry. 2015 Mar;2(3):271-4.
Rapid urbanisation, and transition from traditional lifestyles
(concerning diet, physical activity, and social structures) have
been linked to increases in depression and other mental
disorders
depression and other common mental disorders are part of an
epidemic of comorbidity between physical and mental ill health,
with diet being crucial determinant
shift towards high, less nutritious foods instead of traditional,
more healthful diets
many people are both overfed and undernourished
6. Nutritional medicine as mainstream
in psychiatry (cont’d)
many individuals in affluent nations do not meet recommended
intakes of several brain-essential nutrients, including B-vitamins,
zinc, and magnesium
although slight improvements have been detected in dietary intakes
of sugar and fats, documented intakes of nutrient-rich and fibre-rich
vegetables and whole grains are far lower than recommended
these profound changes in dietary habits, along with tobacco use,
insufficient physical activity, and harmful alcohol and recreational
drug use, have resulted in an epidemic of ill health
Sarris Jet al., International Society for Nutritional Psychiatry Research. Lancet Psychiatry.
2015 Mar;2(3):271-4.
7. Nutritional medicine as mainstream
in psychiatry (cont’d 2)
mechanisms by which nutrition might affect mental health are obvious:
the human brain operates at a very high metabolic rate, and uses a
substantial proportion of total energy and nutrient intake; in both
structure and function
it is reliant on amino-acids, fats, vitamins, and minerals or trace elements
Dietary habits modulate functioning of the immune system, which also
moderates the risk for depression
The antioxidant defence system, which is also implicated in mental
disorders, operates with support of nutrient cofactors and
phytochemicals
Additionally, neurotrophic factors make essential contributions to
neuronal plasticity and repair mechanisms throughout life, and these too
are affected by nutritional factors
Sarris Jet al., International Society for Nutritional Psychiatry Research. Lancet Psychiatry.
2015 Mar;2(3):271-4.
8. Nutritional medicine as mainstream
in psychiatry (cont’d 3)
selected nutrient-based supplements might provide many neurochemical
modulatory activities beneficial in the management of mental disorders
Examples of these nutrient-based supplements include:
omega-3 fatty acids
S-adenosyl methionine (SAMe)
N-acetyl cysteine (NAC)
zinc
B vitamins (including folic acid), and
vitamin D
Various clinical investigations support usefulness of omega-3 fatty acids
for disorders including BPD ,PTSD, and major depression, and they are
indicated in the prevention of psychosis
9. L-Dopa
Tyrosine
Phenylalanin-
Decarboxylase
Vit B6
CO2
SAM-e
SAHom
THB
Phenylalanin- Hydroxylase
Folic acid,
Magnesium
THB
Tyrosin-
Hydroxylase
Folic acid, SAM-e
DHB
NAD(P)H+H+
Tyrosin-
Hydroxylase
Calcium
NAD(P)+
Dopa-
Decarboxylase
Vit B6
CO2
O2
Dopamin-B
Hydroxylase
Vit C, Iron, Copper
H2O
Phenylethanolamin-
N-Methyltransferase
Vit B6, B12,
Folic acid
Dopamine
Adrenaline
Noradrenaline
Phenylalanine
Antoinette Sarasin/Adapted based on specialist brochure,
Ganzimmun, Labor für funktionelle Medizin AG
Co-factors in the synthesis of
neurotransmitters:
Dopamine
11. Vit B6, Vit B12, Mg
Glutamat-
Decarboxylase
CO2
NH2
Glutamin-
synthetase
Glutamat-
dehydrogenase
NH2
Transaminierung
Vit B6, Vit B12, Mg
a-Ketoglutarat
Glutamat
Glutamine GABA
GABA
Antoinette Sarasin/Adapted based on specialist brochure,
Ganzimmun, Labor für funktionelle Medizin AG
12. Epigenetics, nutrition and mental
health. Is there a relationship?
Many aspects of human development and disease are influenced by the interaction
between genetic and environmental factors.
Understanding how our genes respond to the environment is central to managing
health and disease and is one of the major contemporary challenges in human
genetics.
Various epigenetic processes affect chromosome structure and accessibility of
deoxyribonucleic acid (DNA) to the enzymatic machinery that leads to expression of
genes.
One important epigenetic mechanism that appears to underlie the interaction
between environmental factors, including diet, and our genome, is chemical
modification of the DNA.
The best understood of these modifications is methylation of cytosine residues in
DNA.
It is now recognized that the pattern of methylated cytosines throughout our genomes
(the ‘methylome’) can change during development and in response to environmental
cues, often with profound effects on gene expression.
Aaron J. Stevens, Julia J. Rucklidge & Martin A. Kennedy (2018) Epigenetics, nutrition
and mental health. Is there a relationship?, Nutritional Neuroscience, 21:9, 602-613
13. The Relationship between Nutrition
in Infancy and Cognitive
Performance during Adolescence.
Nyaradi A, Oddy WH, Hickling S, Li J, Foster JK. Front Nutr.2015 Feb 11;2:2.
investigate the long-term associations between breastfeeding
duration during infancy, diet quality and cognitive performance
during adolescence.
Results: Higher diet scores at 1 year representing better diet quality
were significantly associated with faster reaction times in cognitive
performance at 17 years
14. impact of diet-based glycaemic response and
glucose regulation on cognition: evidence across
the lifespan
The brain has high metabolic rate and its metabolism is almost entirely
restricted to oxidative utilisation of glucose
Thisemphasises extreme dependence of neural tissue on a stable and
adequate supply of glucose.
initially thought that only glucose deprivation (i.e. under hypoglycaemic
conditions) can affect brain function, it has become apparent that low-level
fluctuations in central availability can affect neural and consequently,
cognitive performance
although acute rise in blood glucose levels has some short-term
improvements of cognitive function, a more stable blood glucose profile,
which avoids greater peaks and troughs in circulating glucose is associated
with better cognitive function and a lower risk of cognitive impairments in the
longer term.
Therefore, a habitual diet that secures optimal glucose delivery to the brain
in the fed and fasting states should be most advantageous for the
Sünram-Lea SI, Owen L. The impact of diet-based glycaemic response and glucose regulation on
cognition: evidence across the lifespan. Proc Nutr Soc. 2017 Nov;76(4):466-477 Review
15. Potential for primary prevention of
Alzheimer’s disease: an analysis of
population-based data
Reduction of risk factors:
Diabetes mellitus
Midlife hypertension
Midlife obesity
Physical inactivity
Depression
Smoking
Low educational attainment
Conclusion:
around a third of Alzheimer’s diseases
cases worldwide might be attributable to
potentially modifiable risk factors
Alzheimer’s disease incidence might be
reduced through
improved access to education and
use of effective methods targeted at
reducing prevalence of vascular risk
factors (e.g. physical inactivity, smoking,
midlife hypertension, midlife obesity,
and diabetes) and depression)
Norton S, Matthews FE, Barnes DE, Yaffe K, Brayne C. LancetNeurol. 2014
Aug;13(8):788-94.
16. The role of diet and nutrition in dementia
The consequences of poor diet also impact on a global health
hazard: obesity.
Alzheimer’s disease and depression are comorbidities of obesity,
leading to the theory that vascular impairments may have a role in
the development of dementia and psychiatric pathologies.
As a result of these observations, Alzheimer’s disease and other
dementias are now being thought of as potentially preventable
diseases.
In a 27-year longitudinal study, obesity in mid-life was shown to
double the risk of developing dementia at later age
Moreover, while cognitive deficits have been associated with
glycaemic regulation in diabetes, only in the recent years observed
that cognitive deficits exist in young healthy, normal weight
individuals with poor glucoregulation,
This exemplifies need for early, rather than later life, preventative
nutrition measures
Owen L, Corfe B. The role of diet and nutrition on mental health and wellbeing. Proc
Nutr Soc. 2017 Nov;76(4):425-426
17. Neural Signaling of Food Healthiness
Associated with Emotion Processing
Front Aging Neurosci. 2016 Feb 10;8:16..2016.
Herwig U, Dhum M, Hittmeyer A, Opialla , Scherpiet S, KellerC, Brühl AB, Siegrist M
The ability to differentiate healthy from unhealthy foods important in order
to promote good health
Food, however, may have an emotional connotation, which could be
inversely related to healthiness
Compared individual evaluations of high and low healthiness of food items
found increased activation when food was evaluated to be healthy in the
left DLPC
perceived and rated higher healthiness was associated with lower amygdala
activity and higher ventral striatal and orbitofrontal cortex activity.
18. Under Stress we choose unhealthy food
Neuron. 2015 Aug 5;87(3):621-31. Acute Stress Impairs Self-Control in Goal-Directed
Choice by Altering Multiple Functional Connections within the Brain's Decision Circuits.
Maier SU, Makwana AB, Hare TA
Important decisions are often made under stressful circumstances that
might compromise self-regulatory behaviour
investigated mechanisms in human participants who faced self-control
dilemmas over food reward while undergoing fMRI following stress
found that stress increased the influence of immediately rewarding
taste attributes on choice and reduced self-control
results indicate that stress may compromise self-control decisions by
both enhancing the impact of immediately rewarding attributes and
reducing the efficacy of regions promoting behaviours that are
consistent with long-term goals
19. Gut–brain axis: how the
microbiome
influences anxiety and depression
Foster JA, McVey Neufeld
KA. Trends Neurosci. 2013
May;36(5):305-12. Review.
reciprocal relationship,
with the CNS moderating, e.g.
gut motility and secretion
manipulation of the gut microbiota
with specific probiotics or with
antibiotics can influence
depression-like behaviours
prenatal and early life stress
modulates the microbial
composition of the gut in
infants and suggests
implications for vulnerability to
mental disorders
in children
20. Stress and Microbiota
depressive episodes associated with dysregulation of the hypothalamic–
pituitary–adrenal axis, resolution of depressive systems with normalization of
the HPA axis
Gut microbiota play role in programming of the HPA axis early in life and stress
reactivity over lifespan
neonatal stress leads to long-term changes in diversity and composition of gut
microbiota, which contribute to long-term alterations in stress reactivity
concurrent treatment with probiotics (Lactobacillus sp.) during the early stress
period has been shown to normalize basal cortisol levels
Stress known to increase intestinal permeability (leaky gut)
bacteria directly access both immune cells and neuronal cells of the ENS
potential pathway whereby microbiota can influence CNS via immune system
and ENS in presence of stress
Foster JA, McVey Neufeld KA. Trends Neurosci. 2013 May;36(5):305-12. Review.
21. Leaky Gut
gut barrier controls flow of molecules between gastrointestinal tract and
bloodstream
Compromised integrity of barrier been termed ‘leaky gut’
associated with a wide range of intestinal and systemic diseases, including
allergies, autoimmune disorders, asthma, IBD and, speculatively, to mental health
consequence of leaky gut, is increase in circulating bacteria derived
lipopolysaccharide which triggers immunological and inflammatory response
increased systemic pro-inflammatory cytokines
Inflammation suggested causative factor in depression
Bacterial translocation across the gut wall induces an autoimmune response to
serotonin associated with fatigue and illness behaviour
Dash S, Clarke G, Berk M, Jacka FN. The gut microbiome and diet in psychiatry:
focus on depression. Curr Opin Psychiatry. 2015 Jan;28(1):1-6.
22. Biomarkers and clinical staging in
Psychiatry
McGorry P, Keshavan M, Goldstone S, Amminger P, Allott K, Berk M, Lavoie S,Pantelis
C, Yung A, Wood S, Hickie I. Biomarkers and clinical staging in psychiatry. World
Psychiatry. 2014 Oct;13(3):211-23.
it is during the early stages of a disorder that interventions have the potential
to offer the greatest benefit
progression of illness is by no means inevitable, but can be altered by
providing appropriate interventions that target individual modifiable risks and
protective factors
23. Biomarkers and clinical staging in
Psychiatry
McGorry et al. Biomarkers and clinical staging in psychiatry. World Psychiatry. 2014
Oct;13(3):211-23.
Possible targets of interventions
24. Inflammatory and oxidative stress
marker
increasing evidence to implicate inflammatory processes in the
pathophysiology of major psychiatric disorders
Elevated levels of cytokines are a well-replicated finding in most major
mental illnesses
Elevated levels of pro-inflammatory cytokines appear to precede the
development of de novo disorder, suggesting that they play a role in its
genesis
consistent body of evidence for an increase in oxidative stress in mood
and psychotic disorders, including reduction in brain glutathione levels,
changes in antioxidant enzymes, lipid peroxidation
McGorry et al. Biomarkers and clinical staging in psychiatry. World Psychiatry. 2014
Oct;13(3):211-23.
25. Inflammatory and oxidative stress
marker (cont’d)
Evidence that most established psychotropic agents, including mood stabilizers and atypical
antipsychotics, have substantive impacts on oxidative and inflammatory pathways
selective COX-2 blocker displays potential efficacy in the treatment of bipolar disorder
and schizophrenia
use of statins, which have anti-inflammatory and antioxidant properties, associated with
lowered risks of mood disorders in community studies
N-acetylcysteine, which has antioxidant and anti-inflammatory properties, shows preclinical
and clinical efficacy in bipolar disorder and schizophrenia and is a potential neuroprotective
candidate
Aspirin appeared to reduce the symptoms of schizophrenia in a placebo-controlled trial and
was linked to less progression of disease in bipolar disorder
in a pharmaco-epidemiological study Minocycline, which has antioxidant and anti-
inflammatory properties, has potential in diverse illness models
McGorry et al. Biomarkers and clinical staging inpsychiatry. World Psychiatry. 2014
Oct;13(3):211-23.
26. Fatty acids marker (cont‘d)
Phospholipids are main structural elements of all cell membranes
polyunsaturated fatty acids (PUFAs) play central roles in broad range
of physiological functions e.g. signal transduction, receptor sensitivity
Are precursors, which mediate inflammatory response
have neuro-protective effect.
PUFAs are essential fatty acids
since humans are unable to synthesize them de novo, they must be
sourced in diet
Typical Western diet contains low levels of anti-inflammatory omega-
3 fatty acids and high levels of pro-inflammatory omega-6 fatty acids
and saturated fatty acids, leading to increased production of pro-
inflammatory eicosanoids
This imbalance has pathological consequences, and is a promoter of
chronic disease
McGorry et al. Biomarkers and clinical staging in psychiatry. World Psychiatry. 2014
Oct;13(3):211-23.
27. Fatty acids marker (cont‘d 2)
McGorry et al. Biomarkers and clinical staging in psychiatry. World Psychiatry. 2014
Oct;13(3):211-23.
In relation to mental health, omega-3 PUFAs may play role in pathogenesis
of major affective and psychotic disorders
patterns of these fatty acid alterations are not specific to depression, but
are also found in other conditions accompanied by increased oxidative
stress, such as Alzheimer’s disease, bipolar disorder, schizophrenia, and
during normal ageing
study in a cohort of 33,000 women from the general population found
relationship between dietary intake of fish (the richest dietary source of PUFAs)
and vitamin D and psychotic-like symptoms
also preliminary evidence that fatty acid deficits may be present during the early
of psychotic disorders.
28. Sleep and chronobiological
markers
characteristic of onset of most major psychiatric disorders is disruption of
sleep, often accompanied by shifts in the sleep-wake cycle
Shortened sleep duration appears to be a risk factor to the onset of common
forms of psychological distress
Poly-somnographic studies have received relatively little attention in recent
years, because of lack of diagnostic specificity
There appear to be distinct sleep “signatures”, with consistent reductions in
slow wave sleep in schizophrenia, and shortened rapid eye movement
latency and increases in REM density in depression
McGorry et al. Biomarkers and clinical staging in psychiatry. World Psychiatry. 2014
Oct;13(3):211-23.
29. Sleep problems in the general
population (age 20-40)
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
Class 1: NO
Class 2: SM
Class 3: SI
Roughly ¼ suffers from sleep problems (approx. 18% sleep misperception, 7% severe
insomnia)
mental health problems strongly related to patterns of sleep disturbances, e.g. affective disorders,
in particular major depression and dysthymia
also concomitant with a broad range of mental health problems below the diagnostic threshold
(e.g. Burnout).
Sleep misperception:
symptoms of initiating
sleep, frequent
awakening during the
night and to a lesser
degree early awakening
Severe insomnia: broad
range of symptoms,
such as difficulties to get
up in the morning,
initiating sleep, frequent
awakening, early
awakening, anxiety
during the night and
nightmares,
Rössler et al. Sleep disturbances in young adults. Empirical patterns and related factors from an
epidemiological survey, Compr Psychiatry. 2017 Oct;78:83-90
30. Diet, Sleep, Exercise and
DepressionLopresti AL, Hood SD, Drummond PD. A review of lifestyle factors that contribute to
important pathways associated with major depression: diet, sleep heightened cortisol
secretion and exercise. J Affect Disord. 2013 May 15;148(1):12-27.
heightened cortisol
secretion
hypersecretion of
corticotropin-releasing
hormone (CRH)
Successful treatment with
antidepressants is
associated with a
normalisation of HPA axis
activity and restoration in
glucocorticoid receptor
function
reduced plasma concentrations of important antioxidants (vitamin C,
vitamin E and coenzyme Q10)
reduced antioxidant enzyme activity such as glutathione peroxidase
these deficiencies in antioxidant defenses impair protection against
reactive oxygen species (ROS), leading to damage to fatty acids, proteins
and DNA
Elevated levels of C-reactive protein (CRP), interleukin-1 (IL-1), and
interleukin-6 (IL-6) reported in a meta-analysis on depression in clinic
and community samples
31. Relationship between Diet an
Depression
Lopresti et al. A review of lifestyle factors that contribute to important pathways
associated with major depression: diet, sleep heightened cortisol secretion and exercise. J
Affect Disord. 2013 May 15;148(1):12-27.
association between diet and depression has now been confirmed in prospective and
epidemiological studies:
consumption of fish, vegetables, olive oil, and cereal correlated negatively
with the severity of depressive symptoms
adherence to Mediterranean diet comprising high levels of vegetables, fruit,
nuts, cereal, legumes, and fish, moderate alcohol intake, and low
consumption of meat or meat products and whole-fat dairy, was protective
against the development of depression
Depressive symptoms are positively associated with the consumption of
sweets
Similarly, high intake of fast food (hamburgers, sausages, pizza) and processed
pastries (muffins, doughnuts, croissants) are associated with increased risk of
depression up to 6 years later investigations on the relationship between
nutrients and depression have demonstrated a role of folate and omega-3
essential fatty acids
32. Diet and its effect on
inflammation
Lopresti et al. A review of lifestyle factors that contribute to important pathways
associated with major depression: diet, sleep heightened cortisol secretion and exercise. J
Affect Disord. 2013 May 15;148(1):12-27.
strong evidence in human studies that adherence to a Mediterranean diet is
associated with reduced inflammatory markers
In a study on people with metabolic syndrome, five weeks on a Mediterranean
diet corresponded with lowered plasma CRP and an arbitrary inflammatory score
that included CRP, IL-6, IL-18, and TNF-a
CRP levels were lower in an elderly population on a Mediterranean diet compared
to a standard ‘healthy diet’ comprising a high intake of fruits and low
consumption of eggs, spirits or liqueurs, and meats such as bacon, pork, lamb,
and sausages
fatty acids were able to partly inhibit a number of aspects of inflammation
33. Diet and its effect on oxidative
stress
Given the crucial role that diet plays in antioxidant intake, diet quality also
influences levels of oxidative stress
In obese adults with metabolic syndrome, reducing energy intake by 2000
kJ, mainly via carbohydrate restriction, was associated with decreased
oxidative stress and increased levels of antioxidant markers
Mediterranean diet is associated with increased circulating plasma
antioxidant levels and decreased oxidative stress
Lopresti et al. A review of lifestyle factors that contribute to important pathways
associated with major depression: diet, sleep heightened cortisol secretion and exercise. J
Affect Disord. 2013 May 15;148(1):12-27.
34. Sleep and its effect on
inflammation, oxidative stress and
HPA axisLopresti et al. A review of lifestyle factors that contribute to important pathways
associated with major depression: diet, sleep heightened cortisol secretion and exercise. J
Affect Disord. 2013 May 15;148(1):12-27.
Inflammation
Sleep difficulties increase inflammatory mediators; conversely elevated
inflammatory molecules heighten the risk of sleep problems
IL-1, IL-6 and TNF-a may be directly involved in sleep regulation
cytokines are sleep regulatory, as they support the regulation of
spontaneous sleep–wake behaviour
In patients with major depression, difficulty initiating sleep correlated
with increased pre-sleep levels of IL-6
oxidative stress:
difficulty falling asleep was related to higher morning levels of CRP and
IL-6
proposed that cerebral free radicals accumulate during wakefulness
and are removed during sleep
HPA axis
Cortisol levels were also positively correlated with the severity of
reported sleep disturbance
35. The relationship between Exercise
& Depression
investigations into sedentary behaviours largely confirmed a positive
relationship with depression
Depression is commonly associated with low levels of physical activity
studies do not necessarily confirm causation, but consistent relationship
does exist
In adults, active lifestyle associated with reduced depressive symptoms
In overweight/obese adults, reduced risk of depression was associated with
increasing moderate-to vigorous-intensity physical activity and decreasing
sedentary time
In a longitudinal study of over 9000 people, regular physical activity was
associated with a reduced likelihood of depressive symptoms at follow-up
Lopresti et al. A review of lifestyle factors that contribute to important pathways
associated with major depression: diet, sleep heightened cortisol secretion and exercise. J
Affect Disord. 2013 May 15;148(1):12-27.
36. Exercise and its effect on
Inflammation, oxidative Stress and
HPA Axis
exercise is followed by an increase in anti-inflammatory cytokines and a
decreased production of the pro-inflammatory cytokines TNF-a and IL-1b
exercise results in an up-regulation of antioxidant enzymes, thus exercise
itself can be considered an antioxidant despite generating free radicals
In a study on female adolescents with mild-to-moderate depression, 8 weeks
of an exercise regimen improved depressive symptoms and was associated
with reductions in 24 h urinary cortisol levels
Lopresti et al. A review of lifestyle factors that contribute to important pathways
associated with major depression: diet, sleep heightened cortisol secretion and exercise. J
Affect Disord. 2013 May 15;148(1):12-27.
37. Assessing the Potential and Limitations of Leveraging Food Sovereignty to Improve
Human Health Andrew D. Jones1 , Lilly Fink Shapiro and Mark L. Wilson REVIEW
published: 23 November 2015
Food Sovereignty to improve Human
(mental) Health
Food sovereignty has been defined as "the right of
peoples to healthy and culturally appropriate food
produced through ecologically sound and sustainable
methods, and their right to define their own food and
agriculture systems”
Human health is an implied component of this definition
through the principle of healthy food
concerted effort to generate new empirical evidence on the
health implications of these domains of food sovereignty is
urgently needed
38. Conclusions
While the importance of lifestyle factors such as diet, exercise and sleep are
generally acknowledged in research literature, the mechanisms of their potential
influence are often not fully understood
exercise and sleep can influence several physiological pathways
A bi-directional relationship likely exists between several mental disorders and
these lifestyle factors
a multitude of other lifestyle influences may also be important e.g. chronic stress,
social influences, mental and physical effects associated with medical diseases,
alcohol and other drug use, chronic pain or even exposure to sunlight/vitamin D. It
is these influences, plus array of psychological, genetic and biological factors that
Basic interventions comprising attention towards one cause and/or one
biochemical mechanism (e.g., targeting a single neurotransmitter disturbance)
makes goal of remission or recovery less likely