Advanced nutrition for the brain series: stress, the HPA-axis and neuroinflammation. Targeted nutritional interventions for successful treatment of mental health conditions.
Inflammation is a major contributing factor to chronic modern illness and is driven, in part, by chronic stress and HPA-axis over stimulation. Mental health conditions, in particular clinical depression, are increasingly linked with neuroinflammation. As such, anti-inflammatory interventions are known to result in significant clinical benefits.
During this webinar Dr Bailey will discuss the biological mechanisms linking stress, chronic inflammation and mood disorders, together with a review of the current evidence for a targeted, anti-inflammatory nutrition approach to treatment. Nina will also clarify why some of the recent trials have failed to report benefits and how to optimise your anti-inflammatory interventions to treat clients with anxiety, depression, schizophrenia and PTSD.
The diagnostic assessment and treatment and treatment planning in psychiatry is a dynamic process that integrates the biological, psychological, social, and behavioral paradigms to develop a plan of action that provides a rational for the types of interventions employed to sustain the therapeutic alliance and relieve suffering.
The diagnostic assessment and treatment and treatment planning in psychiatry is a dynamic process that integrates the biological, psychological, social, and behavioral paradigms to develop a plan of action that provides a rational for the types of interventions employed to sustain the therapeutic alliance and relieve suffering.
The association of neuropsychiatric disorders with cerebrovascular disease has been recognized by clinicians for over 100 years. Disease of the vascular system contribute greatly to the sum total of psychiatric disability, chiefly in the elderly population, mainly as a result of stroke, cerebrovascular accidents & subarachnoid haemorrhage.
The term “psychosomatic disorder” is mainly used to mean “a physical disease that is thought to be caused, or made worse, by mental factors.” ... For example, chest pain may be caused by stress and no physical disease can be found.
psychological aspects of Bronchial asthma.Hiba Ashibany
this lecture ( psychological aspects of bronchial asthma) has been presented by Dr. Heba ashebani/ Abusetta chest center, in the event of Global asthma day 2018.
Depressive Disorders: An Overview of Full Spectrum. Dr. Ashok Kumar Batham.DrAshok Batham
Medical specialists outside the area of psychiatry and those who practice family medicine generally get fragmented information about mental depression. Therefore, an endeavour has been made to provide a complete overview of various depressive disorders, such as, Major Depressive Disorder (MDD), Persistent Depressive Disorder (PDD) or Dysthymia, Disruptive Mood Dysregulation Disorder (DMDD), Premenstrual Dysphoric Disorder (PMDD), Substance/Medication Induced Depressive Disorder, Depressive Disorder Due to Another Medical Condition, and other depressive disorders. DSM-5 diagnostic criteria of each of these disorders are given along with vignettes of diagnosis and treatment of the same are presented. Hopefully, this slide share will help non-psychiatrists to understand the complete spectrum of depressive disorders.
The association of neuropsychiatric disorders with cerebrovascular disease has been recognized by clinicians for over 100 years. Disease of the vascular system contribute greatly to the sum total of psychiatric disability, chiefly in the elderly population, mainly as a result of stroke, cerebrovascular accidents & subarachnoid haemorrhage.
The term “psychosomatic disorder” is mainly used to mean “a physical disease that is thought to be caused, or made worse, by mental factors.” ... For example, chest pain may be caused by stress and no physical disease can be found.
psychological aspects of Bronchial asthma.Hiba Ashibany
this lecture ( psychological aspects of bronchial asthma) has been presented by Dr. Heba ashebani/ Abusetta chest center, in the event of Global asthma day 2018.
Depressive Disorders: An Overview of Full Spectrum. Dr. Ashok Kumar Batham.DrAshok Batham
Medical specialists outside the area of psychiatry and those who practice family medicine generally get fragmented information about mental depression. Therefore, an endeavour has been made to provide a complete overview of various depressive disorders, such as, Major Depressive Disorder (MDD), Persistent Depressive Disorder (PDD) or Dysthymia, Disruptive Mood Dysregulation Disorder (DMDD), Premenstrual Dysphoric Disorder (PMDD), Substance/Medication Induced Depressive Disorder, Depressive Disorder Due to Another Medical Condition, and other depressive disorders. DSM-5 diagnostic criteria of each of these disorders are given along with vignettes of diagnosis and treatment of the same are presented. Hopefully, this slide share will help non-psychiatrists to understand the complete spectrum of depressive disorders.
This file accompanies a YouTube file - covering the HPA axis, the Fight-Flight response & the role of cortisol in the stress response. See www.ePsychVCE.com for link
This webinar will give you an interesting insight into the practicalities of working with women and couples as they go through their fertility journey, from pre-conception, through to pregnancy and post-natal recovery. Catherine presents this online lecture through the use of key case studies, highlighting:
• The importance of supporting the adrenals for female fertility, and how this may impact on progesterone levels
• Key functional tests which may help you understand what may be preventing conception and successful pregnancy outcomes
• How to work with women going through assisted conception
• How to become a “fertility detective” and support couples with unexplained fertility issues
• Using a 3 month window between trying to conceive again – key supplements for optimal results
• Managing common problems found in pregnancy - iron deficiency anaemia to hyperemesis gravidarum
• How nutritional therapists can support women before birth and the early post-natal recovery – what really needs to go in the hospital bag!
• Preventing post-natal burn out - many women, especially after their second pregnancy, experience post-natal burn out after roughly 6 to 9 months after birth. Why is this and how we can we support women through this?
The Neurobiology of Depression (Dr Imran Waheed)Imran Waheed
A lecture delivered in the West Midlands by Dr Imran Waheed, Consultant Psychiatrist, on The Neurobiology of Depression. For further information visit www.bhampsych.com
This file accompanies a YouTube clip. It distinguishes allostasis from homeostasis and provides a brief overview of the allostatic response and allostatic load - see facebook page for link to clip - ePsychVCE.com (or website of same name)
The effect of stress on hormone serum level/cortisol the stress hormone/stress as a cause of endocrine disorders such as diabetes mellitus, thyroid storm, obesity and hyperthyroidism/stress and hormones/Disorders caused by high-stress level/prolactin hormone is affected by stress/is growth hormone affected by stress.
This summary focuses on two articles that correlate stress and external factors. The first article by Theodore. B. Vanitallie, (2002) examines the pathology of stress while the research experiment by Bloch, M. (2007) investigates the effect of divorce on stress levels and physiological responses.
Psycho-neuro-immunology (PNI) is the Inter-relationship of Mental Health and the Immune System.
Psychoneuroimmunology is a new area of research looking into: 1) how mental health (stress, depression, etc.) impacts the immune system, and 2) how changes in the immune system (due to sickness) can impact mental health and lead to depression.
A Multimodal, Regenerative Approach to Traumatic Brain Injury - OMED Oct 2020Megan Hughes
Dr. John Hughes discusses traumatic brain injury, the neurobiochemical cascade, and how to treat a TBI with hyperbaric oxygen, adult stem cells, prp, and IV nutrition.
Stress is defined as a state of physiological or psychological strain caused by an adverse stimuli , physical, mental, or emotional, internal or external that tend to disturb the functioning of an organism and which the organism naturally desires to avoid.
Metabolic depression in hibernation and major depression: an explanatory theo...Loki Stormbringer
Metabolic depression, an adaptive biological process for energy preservation, is responsible for torpor, hibernation and estivation. We propose that a form of metabolic depression, and not mitochondrial dysfunction, is the process underlying the observed hypometabolism, state-dependent neurobiological changes and vegetative symptoms of major depression in humans. The process of metabolic depression is reactivated via differential gene expression in response to perceived adverse stimuli in predisposed persons. Behavior inhibition by temperament, anxiety disorders, genetic vulnerabilities, and early traumatic experiences predispose persons to depression. The proposed theory is supported by similarities in the presentation and neurobiology of hibernation in bears and major depression and explains the yet unexplained neurobiological changes of depression. Although, gene expression is suppressed in other hibernators by deep hypothermia, bears were chosen because they hibernate with mild hypothermia. Pre-hibernation in bears and major depression with atypical features are both characterized by fat storage through overeating, oversleeping, and decreased mobility. Hibernation in bears and major depression with melancholic features are characterized by withdrawal from the environment, lack of energy, loss of weight from not eating and burning stored fat, changes in sleep pattern, and the following similar neurobiological findings: reversible subclinical hypothyroidism; increased concentration of serum cortisol; acute phase protein response; low respiratory quotient; oxidative stress response; decreased neurotransmitter levels; and changes in cyclic-adenosine monophosphate-binding activity. Signaling systems associated with protein phosphorylation, transcription factors, and gene expression are responsible for the metabolic depression process during pre-hibernation and hibernation. Antidepressants and mood stabilizers interfere with the hibernation process and produce their therapeutic effects by normalizing the fluctuation of activities in the different signaling systems, which are down-regulated during hibernation and depression and up-regulated during exodus from hibernation and the hypomanic or manic phase of mood disorders. The ways individuals cognitively perceive, understand, communicate, and react to the vegetative symptoms of depression, from downregulation in energy production, and in the absence of known medical causes, produce the other characteristics of depression including guilt, helplessness, hopelessness, suicidal phenomena, agitation, panic attacks, psychotic symptoms, and sudden switch to hypomanic or manic episodes. The presence of one or more of these characteristics depends on the person's neuropsychological function, its social status between the others, and the other's response to the person. Neurobiological changes associated with metabolic depression during entrance, maintenance, and exodus from hibernation in bears is suggested a
inflammatory bio marker for treatment response in first episode psychosis Mohamed Ghamry
Biomarkers are objective measures that can provide information on a variety of different clinical characteristics.
Cytokines as Biomarkers for Anti-inflammatory Treatments.
Cytokines and psychosis.
Hormonal Stress Biomarkers.
LOWERED CORTISOL AWAKENING RESPONSE.
This lecture on the relevance of hormonal optimization in mental health, was presented by Dr. Cady in Salt Lake City, UT at the 2012 Medical Seminar Series coordinated by World Link Medical.
Dr. Michael Antoni of Sylvester Comprehensive Cancer Center discussed stress management for cancer patients at the 2011 WellBeingWell Conference in Miami.
Strategies to prevent depletion of Testosterone and the resulting muscle loss (Sarcopenia ) due to Aging. Stay Young.. Strong and Lively. Andraiz T of Body Satva Essentials on www.bodysatva.com
With a growing number of conditions being grouped under the ‘umbrella’ of autoimmune disease, supporting clients who are, increasingly, presenting with various, and often multiple, autoimmune conditions, can appear complex at first glance.
In this webinar, Dr Danielle Crida outlines a clinical protocol that can support most autoimmune conditions, and takes a deep dive into the role of the immune system and key inflammatory processes at play.
Many clients take bone health for granted until they’re presented with a diagnosis of osteoporosis, often following a fracture. Whether your client is nutrient deficient, concerned about bone health, or diagnosed with a metabolic bone disease, adding the right nutrients to a protocol is paramount.
In her latest webinar, Dr Danielle Crida discusses:
- The importance of bone health
- Consequences of low bone mineral density
- The most important nutrients for bone health and their synergistic roles
- Exercise and lifestyle choices for bone strength
- Supplement and dosing recommendations, introducing our new Ca/Mg/D3/K2/Boron product
Did you know that food storage and preparation can hugely affect its nutritional value? For example, the antioxidant capacity of blueberries actually increases with freezing, and letting crushed garlic rest for 10 minutes before cooking allows for the development of compounds with amazing health benefits.
Learn the tricks of the trade for getting the most out of your food in this short webinar with nutritionist Dr Danielle Crida.
Confused about what to eat for better health? Dr Danielle Crida, trained medical doctor and nutritionist, will guide you through the basic ingredients of a nutritious and delicious diet. This short webinar will discuss how to build the foundations of your meals with macronutrients, and provide tips on how to ensure you are meeting your requirements for vitamins and minerals. We know getting started is the hard part, so we’ll provide a free editable shopping list and tips for a kitchen clearout to set you up for success.
Magnesium plays a role in over 300 biochemical reactions, therefore affecting almost every system of the body when levels are insufficient. In her latest webinar, Dr Danielle Crida focuses on the important role magnesium plays in all stages of a woman’s life, supporting:
- Menstrual cramps
- A healthy pregnancy and postpartum
- Menopausal symptoms, such as hot flushes and mood changes
- Women-predominant conditions, e.g. osteoporosis and thyroid conditions
Veganism is on the rise due to growing concerns about the environment and perceived health benefits. However, certain nutrients such as EPA & DHA are difficult to obtain from plant-based diets. Until recently, the only supplemental source of long-chain omega-3s was fish oil. Igennus has recently launched a vegan omega-3 product which combines algae-sourced EPA & DHA with the additional benefit of astaxanthin, a powerful antioxidant.
In this hour-long webinar, Dr Danielle Crida discusses:
- The importance of omega-3s and the omega 6:3 ratio
- Vegan options for omega-3 supplementation
- Our new Vegan Omega-3 & Astaxanthin product
- How to assess omega-3 requirements and measure response to supplementation
- Ensuring optimal nutrition on a plant-based diet: common nutrient deficiencies and how to address them
While Lyme disease is considered to be relatively uncommon in the UK, it is likely that many cases are simply undiagnosed, many of which turn up in our clinics frustrated by conventional approaches to managing their symptoms. Being able to identify clients with suspected Lyme disease is vital, as many cases that present with early or initial symptoms of fever, headache or other neurological symptoms as a consequence of a tick-borne bacterial infection, simply do not relate these symptoms to having been bitten. As such, this highlights the importance of the need to take comprehensive and detailed client history notes, certainly when a client is reporting symptoms that have not responded to conventional interventions.
With appropriate antibiotic treatment, most patients with early-stage Lyme disease recover rapidly and completely. Signs and symptoms of Lyme disease, however, vary by disease stage, and because many individuals who present with symptoms fail to recall a history of a tick bite or to report the classic bulls-eye rash, they often miss out on what is a relatively narrow window of opportunity to prevent the condition from progressing.
As Lyme disease is a multi-system illness, if left untreated, it can progress to affect the skin, joints, immune system, nervous system, or other vital organs, with many of the symptoms becoming indistinguishable from other multi-system conditions such as fibromyalgia or chronic fatigue syndrome.
In this hour-long webinar, Dr Nina Bailey discusses strategies for practitioners to help identify and manage symptoms of Lyme disease.
Around 250,000 people in the UK are currently thought to be affected by CFS/ME. The high level of disability that is often associated with this debilitating condition can be both physically and mentally challenging for patients and appears to stem from a combination of symptoms such as fatigue, pain, sleep disturbance, cognitive impairment, depression and, in many cases, symptoms mirroring those of irritable bowel syndrome.
With no current cure and no validated, universally accepted, ‘one-size-fits-all’ approach to the treatment, many clients are seeking natural alternatives to conventional approaches.
Taking a personalised and functional medicine approach, Dr Nina Bailey reviews the latest science on ME/CFS and the underlying mechanisms that can be targeted with nutritional interventions and explains how to ensure your therapeutic approach is right for your clients.
Covered in the webinar:
1. CFS/ME background /causes/symptoms
2. Update on the mechanisms associated with CFS/ME:
- Immune disturbances
- Oxidative stress and inflammation
- The kynurenine pathway and neurotransmitter dysregulation
- Mitochondrial dysfunction and related mechanisms
* Methylation
* Detoxification
* Glycolysis
* Citric acid cycle/Krebs
* Oxidative phosphorylation
3. An overview of current treatment options
4. Nutritional intervention – an evidence-based approach
5. Nutritional supplementation
As healthcare practitioners, we are well aware of the endless benefits of vitamin C in supporting immune health, antioxidant support, energy production, collagen formation, nervous system function and iron absorption. Faced with a huge array of vitamin C products, however, how can we be confident we’re recommending the best supplement to our clients?
During R&D for our latest addition to the Igennus Healthcare Nutrition synergistic range of supplements, we were impressed by both the high absorption of Ester-C and the unprecedented uptake and retention in immune cells. Ester-C boasts an impressive 10x higher bioavailability in leukocytes, whilst its pH neutral composition means it’s also gentle on the stomach.
In this webinar, Dr Danielle Crida discusses:
- A recap of vitamin C basics
- The research that led to the production of Ester-C
- The case for Ester-C: success in clinical use above standard vitamin C supplements
- Practical applications and dosing
As natural healthcare practitioners, we all understand the pivotal and complex role that magnesium plays. Required for over 300 biochemical reactions and metabolic functions including cellular signalling, function & energy production, it is no surprise magnesium is one of the most used supplements in a clinician’s toolbox.
Magnesium supplementation is, however, not as straightforward as we are led to believe. With considerations such as carrier, dose and bioavailability to consider, are we really doing clients (and magnesium) justice with a standard ‘go-to’ product?
In this educational webinar, Dr Nina Bailey not only discusses magnesium in clinical practice but, importantly, also uncovers the perils and pitfalls of the magnesium supplement ‘scene’, in the quest to provide clinical excellence, and the important supplemental factors that must be considered to optimise magnesium status and provide clinical efficacy.
Dr Bailey discusses:
1. A brief overview of the clinical implications of magnesium deficiency
2. Magnesium in practice:
-Supporting digestive complaints and overcoming
malabsorption
-The importance of magnesium for structural support
-Supporting energy levels and insulin sensitivity
3. How to ensure clinically effective dosing and supplementation
The imbalance between free radical production and endogenous antioxidant defence may result in cellular oxidative stress, causing oxidative damage to various cellular components, such as DNA, proteins and membrane lipids. The human system employs the use of endogenous enzymatic and non-enzymatic antioxidant defence systems against the onslaught of free radicals and oxidative stress.
Unsurprisingly, oxidative damage has been implicated in and is believed to be a key factor causing various pathological conditions, such as cardiovascular disease, neurodegenerative disease, diabetes and cancer. Free radicals can be quenched through a number of mechanisms. Antioxidants directly scavenge free radicals (e.g., via hydrogen atom transfer or electron transfer), prevent free radical formation by chelating metal ions and by interrupting the radical chain reactions of lipid peroxidation, thus retarding its progression. Enzymatic antioxidants include superoxide dismutase, catalase, glutathione peroxidase and glutathione reductase. Non-enzymatic antioxidants include vitamins A, C, and E, glutathione, alpha-lipoic acid, carotenoids, and coenzyme Q10. Other antioxidants include polyphenols, minerals (copper, zinc, manganese, and selenium), and cofactors (B-vitamins). Together, antioxidants work synergistically with each other using different mechanisms against different free radicals and stages of oxidative stress.
The benefits associated with antioxidants are numerous and diverse but it can be a minefield when choosing the appropriate antioxidant support for clients. In this hour-long webinar, Dr Nina Bailey discusses the direct and indirect benefits and actions of key antioxidants including (but not limited to) astaxanthin, alpha lipoic acid, polyphenols and co-enzyme Q10, with a focus on:
-Antioxidant sources and benefits
-Mechanisms and actions
-When to combine antioxidants for synergistic effects
-Overcoming bioavailability issues
-Targeted intervention, which antioxidant(s) and why
Astaxanthin, the naturally occurring carotenoid responsible for the pink-red pigmentation of wild salmon and crustaceans such as shrimp and lobsters, is a potent and effective antioxidant that boasts an ability to combat oxidative stress 6000x greater than that of vitamin C, 800x coenzyme Q10, 550x vitamin E and 75x alpha lipoic acid. Naturally, we are very excited to introduce AstaPure astaxanthin to our Pure Essentials range, launching in March!
Most commonly associated with preventing age-related diseases, astaxanthin’s unique chemical structure that spans the cell membrane gives rise to an exciting and diverse array of health benefits. New research is coming out daily suggesting astaxanthin is a highly effective tool in combating age-related diseases and cardiovascular disease, as well as boosting the immune system, liver and brain function.
Join Dr Nina Bailey for this ‘Introductory’ ingredient training webinar and discover:
Astaxanthin’s most exciting mechanisms of action
How its unique structure makes it so potent
An overview of some of the most compelling research into astaxanthin’s health benefits
When to use astaxanthin in clinical practice & dosing guidelines
Fibromyalgia syndrome is a common chronic pain condition that affects at least 2% of the adult population. Chronic widespread pain is the defining feature of FM, but patients may also exhibit a range of other symptoms, including sleep disturbance, fatigue, irritable bowel syndrome, headaches and mood disorders. While the aetiology of the condition is not completely understood, it is believed that a number of factors (rather than one in isolation) are most likely to lead to its development. Thus, the onset of fibromyalgia syndrome can be influenced by hormonal and/or chemical imbalances, chronic stress and/or a traumatic event, genetic predisposition and even pre-existing illness.
In this hour-long webinar, Dr Nina Bailey covers:
• An overview of the aetiology of fibromyalgia
• The signs and symptoms of fibromyalgia
• Factors that can contribute to or exacerbate fibromyalgia syndrome
• Managing symptoms via dietary manipulation and lifestyle change
• Supporting nutrients/supplements for those with fibromyalgia syndrome
Histamine intolerance (which can easily be mistaken for an IgE reaction) results from the imbalance of accumulated histamine and the capacity for histamine degradation. Symptoms of histamine intolerance are diverse in nature because histamine exerts its numerous biological reactions via 4 receptors, located on target cells in various tissues, with the severity of symptoms dependent on circulating histamine levels. The signs and symptoms of histamine intolerance can often be misinterpreted or simply go undetected in many individuals.
In this hour-long webinar, Dr Nina Bailey covers:
· The biological roles of histamine and how/why histamine intolerance arises
· The signs and symptoms of histamine intolerance
· High histamine foods/histamine liberators
· Factors that can contribute to or exacerbate histamine intolerance
· How to optimise your diet to reduce histamine reactions
· Supporting nutrients/supplements for those with histamine intolerance
Polycystic ovary syndrome (PCOS) is a common hormonal disorder, thought to affect between 4%–8% of women of reproductive age. Due to a lack of awareness, and the dramatic variation in the signs and symptoms between individuals, a large number of women may have PCOS without being at all aware of it. Unless help is sought for common symptoms (including oily skin and recurring acne; irregular, infrequent or absent periods; excess facial and body hair growth; head hair loss or thinning; weight gain) a formal diagnosis may never be made and issues can persist unmanaged until menopause. PCOS is most commonly diagnosed in women hoping to become pregnant, but who experience fertility issues as a result of irregular ovulation or miscarriage. In this webinar, Dr Nina Bailey PhD outlines the key mechanisms in the pathophysiology of PCOS, the signs and symptoms that should trigger further investigation, and the key nutritional strategies that can be adopted to help women manage the condition.
During this webinar, Sophie covers the double-edged sword of inflammation and oxidative stress as driving factors in chronic modern illness and why addressing these factors with nutritional intervention does not always produce the desired effects; it may even, in some cases, be harmful. Taking a personalised and functional medicine approach, Sophie reviews the underlying mechanisms that can be targeted with nutritional interventions and explains how to ensure your therapeutic approach is right for your clients.
Igennus are excited to announce the launch of our new product, Longvida® Curcumin. During this webinar, Dr Bailey reviews the research behind the therapeutic use of curcumin and why Longvida is the world’s most advanced formulation of the nutrient.
Curcumin is a polyphenol compound obtained from the rhizome of Curcuma longa, also known as turmeric. This Indian spice has a long history of use in Ayurvedic medicine as a treatment for inflammatory conditions. Curcumin is well documented for its antioxidant, anti-inflammatory and anti-cancer activities. Although it has been shown to be safe at high doses (12g/d), it is poorly absorbed, undergoes rapid intestinal and hepatic metabolism and is rapidly eliminated from the body. As such, standard curcumin demonstrates poor bioavailability, even at high doses, limiting its therapeutic potential.
After much research and discussion (it’s a big and complicated topic!) between the Igennus nutrition scientists, the decision as to which type of curcumin we would use for our Synergistic Nutrients range was actually a very straightforward one. Longvida Curcumin utilises a novel delivery system (SLCP), which protects curcumin from the harsh environment of the stomach and promotes its rapid absorption into the bloodstream and target tissues, even at low doses – resulting in an incredible 285x superior bioavaibility compared with standard curcumin, 65x higher peak plasma levels and 7x longer-lasting action. Longvida is the only formulation proven to deliver high levels of free form, unconjugated curcumin, into the bloodstream. Free form curcumin is the form required for therapeutic benefits, and the only form proven to cross the blood brain barrier.
This webinar covers:
- What curcumin is, what it does and how?
- Why free form curcumin is essential for therapeutic effects
- The research and current evidence for Longvida Curcumin’s unique health benefits
- How Longvida overcomes significant bioavailability issues associated with curcumin use
- To who, why and when you should recommend curcumin
…and more.
Nutrition science seems to change on an almost daily basis and much of what was previously considered mainstream or consensus science is being challenged and changed as the new wave of more personalised intervention trials start to clarify many of the reasons behind why nutrition study results can be so conflicting.
No research area, it seems, is more subject to conflicting and confusing results than that of omega-3s which is why, here at Igennus, we do our best to stay on top of ALL the omega-3 research so we can not only help you unpick the fact from fiction (and answer all your questions about every single product on the market!), but also ensure our formulations and education reflect the most cutting edge and clinically proven ingredient research.
Dr Bailey’s ever-growing brain contains a veritable treasure chest of omega-3 knowledge and as we know you are big fans of the work she does, this webinar is dedicated to Dr Bailey’s brain and sharing with you all the latest updates, innovations and applied therapeutic research that she has been reading about over the last year. We aim to help you separate fish oil fact from fiction by answering as many of your omega-3 and fatty acid therapeutic-related questions as possible. Covering everything from which and how much omega-3 to take for certain conditions, how and when taking omega-3 can affect the benefit and amount absorbed, why very high doses can be dangerous, the truth behind what companies and headlines are telling you about omega-3s, to any other areas you want us to cover! We will do our best to cover the most common and important questions and concerns we hear about from you via phone or email and when out and about training in stores and at events every day. As always, we will also clarify some of the reasons behind the frustratingly confusing conflicts in the research and media and what exciting things are coming out of the omega-3 world.
Catherine Jeans has been working with children’s nutrition for the past six years, specialising in family health, including babies, toddlers and teens. Working with children presents various challenges as a nutritional practitioner – not only getting the child to jump on board with the changes, but as important, making sure the parents are able to motivate their child and make the time to help them prepare the right food.
In this webinar, Catherine will go through:
– Logistical challenges – managing parents and their expectations, at what point to include children in consultations and how to talk to children about weight loss, digestive health and sugar.
-The realities of changing a child’s diet – what can you realistically achieve and how to motivate children to change.
– Case studies from babies to teens – Catherine will go through various case studies from her practice, including allergies, food intolerances, Coeliac disease, weight management and sugar addicts.
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
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
2. Acute stressors occur rapidly and
have an obvious onset and
offset; chronic stressors are
ongoing and may not have a clear
endpoint
Brief, predictable stressors are
generally beneficial in terms of
enhancing cognition, emotion
and neurobiological systems such
as the immune system
Chronic, sustained stressors are
considered to be the most
deleterious, contributing to
immune and endocrine
dysfunction, altered mood, and
several neurobiological and
psychological diseases
3. Many physical illnesses are associated with behavioural changes - such as
decreased appetite, weight loss, fatigue, sleep disturbances, impaired cognitive
abilities and depressed mood
• These symptoms appear to result from immune activation and are mediated
by inflammatory cytokines (i.e. IL-1, IL-6 and TNF-α) and named ‘sickness
behaviour’
Similar symptoms (to sickness behaviour) can be induced artificially by the
administration of bacterial endotoxin and IFN-α (given therapeutically for
hepatitis C)
• These IFN-α -induced symptoms can be successfully treated with SSRI
antidepressants, suggesting that the production of inflammatory cytokines
may also underpin the development of depressive illness
4. An excessive level of cortisol is neurotoxic, especially for hippocampal neurones
which play a predominant role in memory and learning
Patients with Cushing's disease (exposed to excessive release of cortisol over long
periods) present with reductions in hippocampal volume that correlate to deficits in
cognitive function and memory (Andela et al. 2013)
Depression, anxiety and cognitive dysfunction, decreased libido, disrupted sleep are
also common in patients with Cushing's disease
In a 1997 study - 66% of Cushing’s patients exhibited psychopathology, consisting
mainly of atypical and major depression as well as anxiety disorder and increased
suicide risk
After three months following treatment (surgery) for hypercortisolemia, this
dropped significantly to 54% and further decreased to 24% after 12months
Starkman 2013; Dorn et al. 1997
5. Elevated cortisol levels and decreased hippocampal volume
The neurotoxic effects of cortisol on the hippocampus may depend on at
least three factors:
the developmental stage of the structure (the hippocampus glucocorticoid
receptors density may change throughout development)
the level and sustainability of cortisol released
the severity and/or duration of the stressful event/s
Bremner 1999
6. Psychological stress
Psychological stressors fall into different categories, depending on the
individual's age during stress exposure, severity and chronicity of the
stressor, and the subjectively perceived threat:
Altered mother-infant interaction (i.e. foster care)
Chronic abuse (physical and mental)
Life-threatening situation (rape, combat situation, natural disaster)
Chronic stressors in adult life (such as loss, financial issues, etc)
7. Early life stress
Stress early in life may induce a vulnerability to stress later in life, resulting in
an increased risk for anxiety, depression and post traumatic stress disorder
(PTSD)
In the pathogenesis of PTSD, fear memory becomes excessively consolidated
and extinction learning doesn’t progress with high comorbidity between
PTSD and depression
Childhood physical abuse predisposes for PTSD development of anxiety
disorders and depression in adulthood and influences its clinical course and
predicts a poorer treatment outcome
Women with a history of childhood abuse are more than twice as likely to
develop depression as non-abused women
Juruena et al. 2015
8. Changes in brain structure in mood disorders
Dysregulation of the HPA-axis/elevated cortisol is strongly implicated in the
pathology of major depressive disorder and are also key features in
neurodegenerative disease
MRI scans and post mortem studies show that depression is related to changes
in regions of the brain relating to mood (i.e. the temporal lobes, medulla and
hippocampus)
Levels of neurotrophins such as Brain-Derived Neurotrophic Factor (BDNF)
involved in neuronal survival and synaptic plasticity, are lower in patients with
major depression, bi-polar depression and animal models of depression
Du & Pang 2015
9. Cortisol and long-chain omega-3 fatty acids
Studies have found a modulating effect of HPA-axis
activity on long-chain fatty acid metabolism
Cortisol influences mobilisation, oxidation and
synthesis of fatty acids
For example, cortisol inhibits Δ5- and Δ6-desaturase-
activity enzymes responsible for unsaturation of fatty
acid chains
High cortisol concentrations are therefore associated
with a decrease in omega-3 EPA and DHA
concentrations
Mocking 2013
DHA
EPA
ETA
SDA
ALA
Δ -6 desaturase
Elongase/desaturase
Δ -5 desaturase
Elongase
11. RBC membrane content of AA versus circulating TNF-α and IL-6
concentrations in healthy adults
Flock et al. 2014
12. Primary structural function &
anti-inflammatory docosanoid
production
Anti-inflammatory eicosanoid
production
REDUCED INFLAMMATION
DHAEPA
Pro-inflammatory eicosanoid
production
INFLAMMATION
AA
AA to EPA ratio
direct antagonism
The relationship between the omega-3 index and the AA to EPA ratio
Omega-3 index
13. There is now an extensive body of data showing that depression is
associated with both a chronic low-grade inflammatory response and
activation of cell-mediated immunity
High AA and low EPA increases the inflammatory ‘potential’
Meta-analyses of 14 studies comparing PUFA levels between
depressive and control subjects
omega-3 levels significantly lower in depressed subjects
compared to controls
Differences in the levels of omega-3 were more pronounced for
individuals with severe depression
Low omega-3 index and a high AA to EPA ratio are associated with
the severity of depression
Conklin et al. 2007; Lin et al. 2010
14. Elevated cytokines are associated with depression
Meta-analysis (18 studies) found significantly increased levels of IL-1β,
IL-6, and TNF-α in post mortem brain samples of suicide victims compared
with brain samples of healthy control individuals who did not die by
suicide
Levels of IL-1β and IL-6 were robustly associated with suicidality
Higher levels of the systemic inflammatory marker IL-6 in childhood (9
years) are associated with and increased risk of developing depression
and psychosis in young adulthood (18 years)
Black et al. 2014; Khandaker et al. 2014
15. Cytokine-induced depression
Intravenous administration of IFN-α for seven days in healthy males
– Volunteers became feverish, fatigued and lacked appetite before
becoming socially withdrawn, slow to answer questions, losing
interest in their surroundings, sleeping most of the day
(Rohatiner et al. 1983)
IFN-α affects HPA-axis activity
– Increased cortisol brought about by IFN-α administration
significantly correlates with depression and fatigue
(Raison et al. 2010)
17. Omega-3 modulates neurotrophins
High omega-3 intake is associated with higher levels of BDNF and is
associated with increased/greater grey matter volume (hippocampus &
amygdala) in healthy individuals (Conklin et al. 2007; Ferreira et al. 2014)
Omega-3 deprivation [animal model] decreases frontal cortex omega-3
content and reduces frontal cortex BDNF expression (Rao et al. 2007)
A potential role of omega-3 in brain trauma
18. Production of
inflammatory cytokines
and catecholamines
Increased activity of
HPA-axis
Increased secretion of
cortisol
Decreased dendritic branching
atrophy/death of neurones
Normal growth and
survival of dendritic
neurones
STRESS
Low omega-3 intake
Reduced omega-3 metabolism
(via ∆ 5 & ∆ 6, desaturase)
19. 5-HIAA/serotonin ratio
After exerting its action in the
postsynaptic neuron, serotonin is
transported back to presynaptic
neuron by specific transporters (SERT)
The serotonin is incorporated again
into vesicles and metabolised to form
5HIAA
When SERT activity is increased, more
serotonin is metabolised to 5HIAA
Therefore, the 5HIAA/serotonin ratio
would be higher
20. Serotonin recycling and degradation
The depletion of tryptophan and subsequent decrease in serotonin production is a
well-established feature of mood disorders pathophysiology (Oxenkrug 2010)
SERT activity is increased by certain pro-inflammatory cytokines, thus reducing
overall serotonin activity (Jazayeri et al.,2010; Song et al. 2007)
Rats fed omega-3-free diets were associated with greater RBC membrane AA
composition and increased plasma IL-6, TNF-α and CRP compared to controls
Both AA levels and AA to EPA ratio are positively correlated with plasma IL-6,
TNF-α, and CRP levels
The 5-HIAA/5-HT ratio is significantly greater in frontal cortex,
hypothalamus, and ventral striatum of omega-3 deficient rats relative to
controls
(McNamara et al., 2010)
21. • Increased HPA-axis activity
• Increased cortisol production
• Increased IDO/TMO/KMO activity
• The kynurenine (KYN)/tryptophan ratio
• Increased SERT activity/low serotonin
• Decreased neurotrophins
• Decreased neurogenesis
• Increased hippocampal atrophy
• Decreased delta-6 desaturase activity
• Increased COX-2, PLA2 & PGE2 activity
Neuroinflammation in mood disorders
High AA to EPA ratio
Low omega-3 status
Cytokines
Cortisol
22. 2012 meta-analysis of 10 studies (including 2,280 subjects)
- EPA and total n-3 PUFAs were decreased in patients with
dementia
- levels of EPA, but not DHA or other PUFAs, were significantly
lower in patients with pre-dementia syndrome
- EPA may act as a disease-state marker AND a risk factor for
cognitive impairment (Lin et al. 2012)
EPA intake is more advantageous than DHA in reducing "brain effort"
relative to cognitive performance (in young adults) (Bauer et al. 2014)
22
Omega-3 and dementia risk
23. Omega-3 increases blood flow to the brain supplying oxygen and fuel delivery, are
essential for neurotransmitter production and function, memory, learning, cognition, and
brain and neurone cell structure
Benefits restricted to those with sub-optimal omega-3 intake!!
24. Increased interest in the use of omega-3 in military settings to
reduce/prevent PTSD and suicide rates
Low EPA and a high AA to EPA ratio is associated with the severity of
the PTSD symptoms in Croatian war veterans (Kalinić et al. 2014)
Subjects with PTSD had significantly higher pro-inflammatory scores
(IL-1b, IL-6, TNF-α, INF-γ and CRP) compared to combat-exposed
subjects without PTSD (Lindqvist et al. 2014)
25. PTSD in severely injured patients
Significant numbers of accident–injured individuals worldwide who are
admitted to intensive care units develop PTSD
1 in 4 patients will develop full-blown or partial PTSD
Hippocampus is crucial for converting short-term memory into long-term
In the pathogenesis of PTSD, fear memory becomes excessively
consolidated and extinction learning doesn’t progress with high comorbidity
between PTSD and depression
Promoting adult neurogenesis by omega-3 supplementation early in the
post trauma period might facilitate the clearance of fear memory from the
hippocampus and consequently minimise PTSD symptoms
26. DHA for the prevention of PTSD in severely injured patients
110 accident-injured patients
3-month daily dose of 1,470mg DHA and 147mg EPA
Primary outcome was total score on the Clinical-Administered PTSD
Scale
Secondary outcome included PTSD diagnosis (full-blown or partial)
Specific effect of DHA on BDNF levels
(Matsuoka et al. 2015a; Matsuoka et al. 2015b)
27. DHA for the prevention of PTSD in severely injured patients
No significant differences in CAPS total score at 3-months (DHA
10.78 vs Placebo 9.22)
11.1% of the DHA group and 5.5% of the placebo group
developed PTSD
RBC omega-3 DHA and EPA in the DHA group significantly
elevated compared to the placebo group (p <0.01)
Changes in BDNF levels at week 12 were inversely associated with
depression severity but with no specific effect of DHA on either BDNF
level
(Matsuoka et al. 2015a; Matsuoka et al. 2015b)
28. DHA group Placebo
Baseline 3-months Baseline 3-months
AA to EPA ratio 10.0 6.5 9.3 8.8
Omega-3 index 7.63 10.58 7.78 8.00
AA 12.33 10.9 11.94 11.58
EPA 1.23 1.64 1.29 1.32
DHA 6.40 8.94 6.29 6.68
Matsuoka et al. 2015a
29. RBC membrane fatty acid composition was determined in first-
episode bipolar manic or mixed (n=40) and healthy (n=40) subjects
At baseline bipolar subjects exhibited significantly lower RBC DHA
levels compared with healthy subjects
EPA , DPA and AA were not different
McNamara et al. 2015
First-episode bipolar disorder is associated with erythrocyte
membrane docosahexaenoic acid deficits
30. Bipolar Healthy controls
AA to EPA ratio 65.9 58.9
Omega-3 index 3.1 3.9
AA 17.5 17.6
EPA 0.28 0.33
DHA 3.1 3.6
McNamara et al. 2015
First-episode bipolar disorder is associated with erythrocyte
membrane docosahexaenoic acid deficits
31. Fatty acid intervention is dependent on
• Omega-3 status
• EPA vs DHA requirements
• AA to EPA ratio ( inflammation)
32. Omega-3 intervention studies meta-analysis findings
•2009 meta-analysis (28 studies) clarified ‘EPA but not DHA to be responsible for
the efficacy of omega-3 long-chain polyunsaturated fatty acid supplementation in
depression (Martins 2009)
•Only those supplements containing EPA ≥ 60% of total EPA + DHA, in a dose
range of 200 to 2,200 mg/d of EPA in excess of DHA, were effective against
primary depression (15 studies) (Sublette et al. 2011)
•It is the EPA in excess of DHA within a supplement that exerts therapeutic effects
(Sublette et al. 2011)
•Meta-analysis of 8 RCTs (high EPA to DHA ration in 7 of the 8) indicate a
beneficial effect of omega-3 monotherapy on depressed mood in women
compared with placebo (Yang et al. 2015)
33. Hamilton Depression Rating Scale (HDRS) total scores after a 12 week
treatment with 1g daily DHA, docosahexaenoic acid or EPA,
eicosapentaenoic acid. *p<0.001.
1g pure EPA more effective
than 1g DHA in treating
depressive symptoms
(Mozaffari-Khosravi et al. 2012)
Pure EPA vs pure DHA in the treatment of clinical depression
34. The effect of EPA supplements in combination with fluoxetine
• Sixty outpatients with a diagnosis of major depressive disorder based on
DSM-IV criteria and a score >or=15 in the 17-item Hamilton Depression Rating
Scale (HDRS) were randomly allocated to receive daily either 1g EPA or 20 mg
fluoxetine, or their combination for 8 weeks
– Response rates (>or=50% decrease in baseline HDRS) were 50%, 56%
and 81% in the fluoxetine, EPA and combination groups, respectively
(Jazayeri et al. 2008)
– EPA alone or in combination with fluoxetine, as well as fluoxetine alone
decreased serum cortisol after 8 weeks
(Jazayeri et al. 2008; Jazayeri et al. 2010)
35. Why is EPA so effective in managing the symptoms of
depression?
EPA to DHA ratio of oils may affect the anti-inflammatory ‘potential’ and
there is evidence to suggest that EPA may be more effective than DHA in
reducing levels of the inflammatory cytokines TNF-a, IL-6 and IL-1β
(Bhattacharya et al. 2007)
Oils with a high ratio of EPA to DHA appear to be more effective in
treating depression and may explain some of the neutral findings reported
in some studies
36. Improves symptoms in
treatment-resistant
depression
Bypasses delta-6
desaturase
Reduces activation of
PLA2 and the release of
AA and PGE2
Reduces hippocampal
atrophy
Normalisation of
BDNF levels
Improved cell survival via
increased neurotrophin
receptor expression
Decreased pro-
inflammatory cytokine
production
Lowers cortisol levels
EPA
Increased production of pro
resolving mediators & anti-
inflammatory eicosanoids
37. In patients with hepatitis C treated with IFN-α up to 45% will
develop depression
IFN-α treatment in hepatitis C patients was associated with an
increase in depressive symptoms and serum kynurenine
concentrations and a decrease in serum concentrations of tryptophan
and serotonin
Low omega-3 and high AA to omega-3 ratio predicts depression
induced by IFN-α treatment
Bonaccorso et al. 2002; Lotrich et al. 2013
38. A 2-week intervention with EPA, DHA or placebo followed by 24 weeks of
IFN-α treatment (n=52)
Compared with placebo, the incident rates of IFN-α-induced depression
were significantly lower in EPA-treated but not in DHA-treated patients
(10% and 28%, respectively, versus 30% for placebo, p = .037)
Both EPA and DHA significantly delayed the onset of IFN-induced
depression (week of onset: 12.0 and 11.7, respectively, versus 5.3 for
placebo, p = .002)
EPA treatment increased both EPA and DHA erythrocyte levels, but DHA
only increased DHA erythrocyte levels
Su et al. 2014
39. EPA’s effects: high vs low inflammatory markers
155 subjects diagnosed with major depressive disorder (as defined by
the Hamilton Depression Rating Scale - HAM-D-17) ≥ 15 were
randomised to 8-weeks of a double-blind treatment with EPA (1060mg)
or DHA (900mg) or placebo
Outcomes were determined using mixed model repeated measures
analysis for ‘high’ and ‘low’ inflammation groups based on individual or
combined biomarkers
(IL-1ra, IL-6, CRP, leptin and adiponectin)
Rapaport 2015
40. EPA’s effects: high vs low inflammatory markers
Although overall group differences were negligible, subjects with any
‘high’ inflammation responded more to EPA than placebo or DHA and
less to DHA than placebo
Subjects identified as being high on any of the five biomarkers were
more likely to respond to EPA than to placebo with DHA and the EPA
placebo separation increasing with increasing numbers of markers of
high inflammation
EPA supplements are more likely to be ‘effective’ where there is pre-
existing inflammation
Rapaport 2015
41. Biomarkers for personalising omega-3 fatty acid dosing
Omega-3 index
an early cardiovascular risk indicator
Omega-6 to omega-3 ratio
an established marker of long-term health and chronic illness
AA to EPA ratio
a measure of ’silent’ or chronic inflammation
A personalised plan aims to achieve:
an omega-3 index of more than 8%
an omega-6 to omega-3 ratio of between 3 and 4
an AA to EPA ratio of between 1.5 and 3
42. ‘RESTORE’
pure EPA
‘MAINTAIN’
EPA, DHA and GLA
Minimum 3-6 months
AA to EPA ratio
Inflammatory regulation
Symptoms of inflammatory illness
Optimum brain, cell, heart, immune
and CNS function
Optimum wellbeing
Omega-3 index
AA to EPA ratio
Long-term general and cellular health
Heart, brain and eye health
Reduce risk of chronic illness and help
protect against inflammatory disease
Therapeutic role of Pharmepa®
RESTORE & MAINTAIN™
43. • Increased HPA-axis activity
• Increased cortisol production
• Increased IDO/TMO/KMO activity
• The kynurenine (KYN)/tryptophan ratio
• Increased SERT activity/low serotonin
• Decreased neurotrophins
• Decreased neurogenesis
• Increased hippocampal atrophy
• Decreased delta-6 desaturase activity
• Increased COX-2, PLA2 & PGE2 activity
Neuroinflammation in mood disorders
High AA to EPA ratio
Low omega-3 status
Cytokines
Cortisol
44. SAMe – metabolism of neurotransmitters
serotonin, melatonin and dopamine
cysteine and glutathione – vital for antioxidant
protection and detoxification processes
DNA – cell cycle, genetic replication, growth
and development
carnitine, choline and CoQ10 – energy
metabolism and mitochondrial function
myelin proteins – nerve transmission and CNS
communication
A healthy methylation cycle – necessary for the production of:
45.
46. Highly bioavailable (‘body-ready’) micronutrient
actives
Formulated at proven dosages for enhanced efficacy
Strong benefits supported with strong health claims
Offers benefits for cardiovascular health, brain
function and mood balance
Synergistic benefits alongside the Igennus clinical
omega-3 range
Small, easy-to-swallow tablets optimised for split-
dosing
Split-dosing overcomes bioavailability issues related
to vitamin B12 intake and maintains optimal blood
levels of key B-vitamins
Suitable for vegetarians & vegans
Suitable for adults and children aged 7+
Nutritional information Per dose % RI*
Vitamin C (ascorbic acid) 160 mg 200
Vitamin B3 (niacin) 48 mg 300
Vitamin B5 (pantothenic acid) 36 mg 600
Vitamin B1 (thiamine ) 20 mg 1818
Vitamin B6 (pyridoxal-5-phosphate) 20 mg 1429
Vitamin B2 (riboflavin-5-phosphate 14 mg 1000
Vitamin B12 (methylcobalamin) 900 µg 36000
Folate ([6S]-5-methyltetrahydrofolate) 400 µg 200
Vitamin B7 (biotin) 300 µg 600
Super B-Complex
47. Igennus MindCare® is the first comprehensive range of targeted brain
nutrition supplements based on four identified consumer need-states.
EPA & DHA +
vitamins E & D
EPA & DHA +
vitamins E & D
EPA & DHA +
vitamins E & D
EPA & DHA +
vitamins E & D
Magnesium glycinate,
L-Theanine &
micronutrients
Acetyl-l-Carnitine,
L-Theanine, taurine,
caffeine &
micronutrients
5-HTP, Magnesium
glycinate &
micronutrients
N-Acetyl L-Cysteine,
alpha-lipoic acid,
resveratrol &
micronutrients
49. Adams, P. B., S. Lawson, et al. (1996). "Arachidonic acid to eicosapentaenoic acid ratio in blood correlates positively with clinical symptoms of depression."
Lipids 31 Suppl: S157-161.
Andela, C. D., S. J. van der Werff, et al. (2013). "Smaller grey matter volumes in the anterior cingulate cortex and greater cerebellar volumes in patients with
long-term remission of Cushing's disease: a case-control study." European journal of endocrinology / European Federation of Endocrine Societies
169(6): 811-819.
Bauer, I., M. Hughes, et al. (2014). "Omega-3 supplementation improves cognition and modifies brain activation in young adults." Human
psychopharmacology 29(2): 133-144.
Bhattacharya, A., D. Sun, et al. (2007). "Different ratios of eicosapentaenoic and docosahexaenoic omega-3 fatty acids in commercial fish oils differentially
alter pro-inflammatory cytokines in peritoneal macrophages from C57BL/6 female mice." The Journal of nutritional biochemistry 18(1): 23-30.
Bremner, J. D. (1999). "Does stress damage the brain?" Biological psychiatry 45(7): 797-805.
Conklin, S. M., P. J. Gianaros, et al. (2007). "Long-chain omega-3 fatty acid intake is associated positively with corticolimbic gray matter volume in healthy
adults." Neurosci Lett 421(3): 209-212
Dorn, L. D., E. S. Burgess, et al. (1997). "The longitudinal course of psychopathology in Cushing's syndrome after correction of hypercortisolism." The Journal
of clinical endocrinology and metabolism 82(3): 912-919.
Du, X. and T. Y. Pang (2015). "Is Dysregulation of the HPA-Axis a Core Pathophysiology Mediating Co-Morbid Depression in Neurodegenerative Diseases?"
Frontiers in psychiatry 6: 32.
Flock, M. R., A. C. Skulas-Ray, et al. (2013). "Determinants of erythrocyte omega-3 fatty acid content in response to fish oil supplementation: a dose-
response randomized controlled trial." Journal of the American Heart Association 2(6): e000513.
Flock, M. R., A. C. Skulas-Ray, et al. (2014). "Effects of supplemental long-chain omega-3 fatty acids and erythrocyte membrane fatty acid content on
circulating inflammatory markers in a randomized controlled trial of healthy adults." Prostaglandins, leukotrienes, and essential fatty acids 91(4):
161-168.
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Editor's Notes
Neurotrophins play a role in the maintenance repair and genesis of neurons including serotonergic and noradrenergic neurones
BDNF is increased in patients receiving SSRI treatment
As a biomarker, the AA to EPA ratio gives an indication of the inflammatory status
Diet has the capacity to influence the amount of polyunsaturated fats within our cell membranes, so we also need a structural biomarker
The omega-3 index = biomarker of intake, but also as risk marker, a risk factor and target for therapy
Combining the AA to EPA ratio with the omega-3 index gives us a comprehensive overview of health status
The kynurenine (KYN)/tryptophan ratio, serotonin and depression
The kynurenine (KYN) pathway, which is initiated by indoleamine 2,3-dioxygenase (IDO), is a main tryptophan metabolic pathway and shares tryptophan with the serotonin (5-HT) pathway
Activation of tryptophan 2,3-dioxygenase (TDO), present in liver and brain, is up regulated by cortisol whilst cytokines activate IDO and kynurenine monooxygenase (KMO) (Oxenkrug 2010)
Not only are serotonin levels reduced as a result of the diversion of tryptophan but elevated quinolinic acid production has neurotoxic effects via agonist actions on N-methyl-D-aspartate receptors (NMDA) triggering neuronal apoptosis, thus further contributing to depressive symptoms (Heyes et al., 1992)
Elevated quinolinic acid accumulation in certain areas of the brain tissue has been reported in depressed patients (Steiner et al., 2011)
ethyl-EPA showed a significantly reduced rate of atrophy in Huntingtons
The role of cytokines on PLA2, COX-2 and PGE2
Cytokines such as IL-1, TNF- increase COX-2
and stimulate signaling pathways leading to PLA2 phosphorylation and AA release (Sun et al., 2004)
Increased levels of PLA2, COX-2 and PGE2 activity is observed in depression, bipolar and schizophrenia
PLA2 has been implicated both in the breakdown and remodelling of phospholipid membranes, with increased activity directly associated with several brain structural alterations as observed in schizophrenia (Smesny et al., 2010)
Low omega-3 status predicts
2008
The role of cytokines on PLA2, COX-2 and PGE2
Cytokines such as IL-1, TNF- increase COX-2
and stimulate signaling pathways leading to PLA2 phosphorylation and AA release (Sun et al., 2004)
Increased levels of PLA2, COX-2 and PGE2 activity is observed in depression, bipolar and schizophrenia
PLA2 has been implicated both in the breakdown and remodelling of phospholipid membranes, with increased activity directly associated with several brain structural alterations as observed in schizophrenia (Smesny et al., 2010)
Oxidative damage, inflammation, demyelination, impaired processing and metabolic deficits are all associated with both neurodegenerative disease and mood disorders?
Could a cocktail of multiple antioxidants with anti-inflammatory agents be beneficial in the prevention of neurodegenerative disease?
Oxidative damage, inflammation, demyelination, impaired processing and metabolic deficits are all associated with both neurodegenerative disease and mood disorders?
Could a cocktail of multiple antioxidants with anti-inflammatory agents be beneficial in the prevention of neurodegenerative disease?