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Archives for January 2015

Nutritional medicine as mainstream in psychiatry

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Home-made grass-fed burger, greens/basil, avocado, sprouts and cheese
Home-made grass-fed burger, greens/basil, avocado, sprouts and cheese

Psychiatry is at an important juncture, with the current pharmacologically focused model having achieved modest benefits in addressing the burden of poor mental health worldwide. Although the determinants of mental health are complex, the emerging and compelling evidence for nutrition as a crucial factor in the high prevalence and incidence of mental disorders suggests that diet is as important to psychiatry as it is to cardiology, endocrinology, and gastroenterology. Evidence is steadily growing for the relation between dietary quality (and potential nutritional deficiencies) and mental health, and for the select use of nutrient-based supplements to address deficiencies, or as monotherapies or augmentation therapies.

I’m excited to share this groundbreaking publication, “Nutritional medicine as mainstream in psychiatry” which was published just last week in the mainstream journal Lancet. We have members of The International Society for Nutritional Psychiatry Research, also known as ISNPR to thank: Jerome Sarris, PhD, Alan C Logan, BA, Tasnime N Akbaraly, PhD, G Paul Amminger, MD, Vicent Balanzá-Martínez, MD, Marlene P Freeman, MD, Joseph Hibbeln, MD, Yutaka Matsuoka, MD, David Mischoulon, MD, Tetsuya Mizoue, MD, Akiko Nanri, MD, Daisuke Nishi, MD, Drew Ramsey, MD, Julia J Rucklidge, PhD, Almudena Sanchez-Villegas, PhD, Andrew Scholey, PhD, Kuan-Pin Su, MD, Felice N Jacka, PhD.

The abstract concludes as follows:

We present a viewpoint from an international collaboration of academics (members of the International Society for Nutritional Psychiatry Research), in which we provide a context and overview of the current evidence in this emerging field of research, and discuss the future direction. We advocate recognition of diet and nutrition as central determinants of both physical and mental health.

You may recognize some of these people from my prior writings and interviews.

Dr. Marlene Freeman is also the author of an editorial, Nutrition and Psychiatry, published in the American Journal of Psychiatry in 2010.

It is both compelling and daunting to consider that dietary intervention at an individual or population level could reduce rates of psychiatric disorders. There are exciting implications for clinical care, public health, and research.

This is one of my favorite quotes! If you’ve ever heard me present I’m sure you’ll recognize it! This was in 2010 so we are making progress with getting nutrition recognized in the mainstream mental health world and I couldn’t be happier.

Here are a few select quotes from the new paper (which will shortly be released as an open-source document).

Mental disorders in general, and major depression and anxiety disorders in particular, account for a large burden of disability worldwide. Rapid urbanisation, and an overall transition from traditional lifestyles (concerning diet, physical activity, and social structures), which are some of the most pressing global and environmental issues of our time, have both been linked to increases in depression and other mental disorders

The mechanisms by which nutrition might affect mental health are, at least superficially, quite 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 (including intracellular and intercellular communication), it is reliant on amino acids, fats, vitamins, and minerals or trace elements.

The purpose of this Personal View is to provide a platform for robust debate in the specialty, particularly regarding the need to move towards a new integrated framework in psychiatry, whereby consideration of nutritional factors should be standard practice.

Diet and nutrition offer key modifiable targets for the prevention of mental disorders, having a fundamental role in the promotion of mental health. Now is time for the recognition of the importance of nutrition and nutrient supplementation in psychiatry. Nutritional medicine should now be considered as a mainstream element of psychiatric practice, with research, education, policy, and health promotion supporting this new framework.

This is so powerful! I commend the efforts of these authors and thank the researchers for all the groundwork which has led to where were are today…recognizing the very powerful connection between what we eat and how we feel. It’s exciting to be part of this movement!

 

Customizing a Low FODMAPS Diet for a Client with Anxiety and/or Depression

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fodmaps-image

Here is an excerpt from a Dec 2014 paper called Review article: the aetiology, diagnosis, mechanisms and clinical evidence for food intolerance:

There have been significant advances in understanding the scientific basis of gastrointestinal food intolerance due to short-chain fermentable carbohydrates (FODMAPs). The most helpful diagnostic test for food intolerance is food exclusion to achieve symptom improvement followed by gradual food reintroduction. A low FODMAP diet is effective, however, it affects the gastrointestinal microbiota and FODMAP reintroduction to tolerance is part of the management strategy.

We’re seeing plenty of people with digestive issues like IBS (Irritable Bowel Syndrome) and SIBO (Small Intestinal Bacterial Overgrowth),  often with accompanying anxiety and depression, and a low FODMAPS diet may need to be considered. How do we know if we should consider it and how do we help out clients make this change?

This webinar is a way for you to learn more about FODMAPS for your clients and it’s a way for me to showcase the valuable work my friend Julie Matthews is doing in her BioIndividual Nutrition™ program. And for us to share the very cool new Victus software. I’ve actually signed up for the next training and I’m just super-excited to get the word out…which is another reason for the webinar! When I learn, I like to share what I learn!

Customizing a Low FODMAPS Diet for a Client with Anxiety and/or Depression

A webinar for health practitioners 
Food Mood Expert Trudy Scott interviews Julie Matthews, co-founder of BioIndividual Nutrition Institute

In this webinar, aimed at health practitioners, we will discuss:

  • The scientific rationale for recommending a Low FODMAPS (an acronym, deriving from “Fermentable, Oligo-, Di-, Mono-saccharides And Polyols) Diet for someone with anxiety/depression
  • Defining oligosaccharides (fructans and galacto-oligosaccharides); disaccharides (lactose); monosaccharides (fructose) and polyols (sugar alcohols and more)
  • What are high free fructose foods and the fructose malabsorption/anxiety and depression connection
  • How to do a low FODMAPs diet elimination/provocation
  • Why would you combine Low FODMAPS and SCD (Specific Carbohydrate Diet) for SIBO (Small Intestinal Bacterial Overgrowth)
  • How the Victus software helps you create a diet/recipes for the Low FODMAPs Diet
  • How to learn more about Julie Matthews’ Bioindividual Nutrition program (for practitioners), other special diets and the upcoming study group

Julie Matthews is a Certified Nutrition Consultant specializing in autism spectrum disorders, ADHD, and nutrition for pregnancy.  Her approached is based on the BioIndividual Nutrition™ needs of each person. She provides dietary guidance backed by scientific research and applied clinical experience. Her award winning book, Nourishing Hope for Autism, has helped people around the world to make food and nutrition choices that aid the health, learning, and behavior of those with autism, ADHD, and other developmental delays. She presents at leading autism conferences in the US and abroad, and is the Nutrition Editor of the Autism File magazine. She is on the scientific advisory board for USAAA (U.S. Autism & Asperger Association) and the Autism Nutrition Research Center. She is the co-founder of Nourishing Hope and BioIndividual Nutrition Institute. Julie has a private nutrition practice in San Francisco, California, and supports families and clinicians from around the world with her nutrition learning tools and professional training courses.

Here is the link to register for the webinar. If you can’t make it at this time, register anyway to get a copy of the notes and audio:

Update: this event is over (it was done Wednesday January 21st, 2015.)  Sorry you missed it!

 

Pyroluria and chronic fatigue syndrome: is there a link?

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pyroluria and chronic fatigue

Last week I blogged about the social anxiety condition called pyroluria (Pyroluria, high mauve, pyrrole disorder, malvaria, elevated kryptopyrroles and social anxiety) and received some great comments on this and the other pyroluria blogs.

One question on this blog: The Anxiety Summit: How zinc and vitamin B6 prevent pyroluria and social anxiety was related to Chronic Fatigue Syndrome/CFS so I’ve decided to share this and some additional information I was able to find.

Hi Trudy, I’m calling from Melbourne Australia, I was wondering if you have had any of your clients present with Chronic Fatigue Syndrome as well as pyroluria. I have just recently been diagnosed with CFS, I also have ADHD. Someone on a CFS forum that I belong to told me about pyroluria and said it is common in ADHD and CFS sufferers. While the link between ADHD and pyroluria is well documented, I haven’t been able to find any information regarding a connection between Chronic Fatigue Syndrome and pyroluria. I notice that there is an overlap of symptoms in the two conditions. I have all of the symptoms of CFS and many of the symptoms of pyroluria. I’m very interested in hearing your views about CFS and how it relates to pyroluria if at all. — Tom

I was not aware of a CFS/pyroluria connection until now but see there is some research showing how CFS and mood disorders/anxiety can have related causes and one of them is inflammation:

An intriguing and hitherto unexplained co-occurrence: Depression and chronic fatigue syndrome are manifestations of shared inflammatory, oxidative and nitrosative (IO&NS) pathways

Low zinc is a factor in pyroluria and depression and of course we may also see low zinc in CFS:

Lower serum zinc in Chronic Fatigue Syndrome (CFS): relationships to immune dysfunctions and relevance for the oxidative stress status in CFS

I find this paper very interesting since many of these same nutrients are commonly low in folks with anxiety and depression: Nutritional strategies for treating chronic fatigue syndrome

A detailed review of the literature suggests a number of marginal nutritional deficiencies may have etiologic relevance. These include deficiencies of various B vitamins, vitamin C, magnesium, sodium, zinc, L-tryptophan, L-carnitine, coenzyme Q10, and essential fatty acids.

I’m surprised the above paper didn’t mention iron anemia.  This is very common with pyroluria.  This paper: Iron insufficiency and hypovitaminosis D in adolescents with chronic fatigue and orthostatic intolerance found this

In patients presenting with chronic fatigue and/or orthostatic intolerance, low ferritin levels and hypovitaminosis D are common

These are just a few of the links I found by doing a very quick pubmed search. There are likely many more.

Everything is so connected and inter-related! And it’s interesting how certain deficiencies can manifest in certain ways – one person may find themselves with a CFS diagnosis, someone else with arthritis and yet someone else with heart disease. I think we need to be thinking about addressing nutrient deficiencies, balancing biochemistry and getting healthy, perhaps more just than addressing a diagnosis.

If you score high on the Pyroluria Questionnaire I would suggest simply addressing the pyroluria which may have some ripple down effects and actually improve the symptoms of CFS.

Now the next post will have to dig into the link between ADHD and pyroluria. Stay tuned.

In the meantime, I’d love to see your comments/questions if you can relate to any of this. Also, please do share in the comments if you know you have pyroluria and find the nutrients have eliminated your social anxiety and inner tension symptoms, and have also helped your CFS.

 

Pyroluria, high mauve, pyrrole disorder, malvaria, elevated kryptopyrroles and social anxiety

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coneflower

Low levels of the mineral zinc and vitamin B6 are frequently associated with a type of anxiety characterized by social anxiety, avoidance of crowds, a feeling of inner tension, and bouts of depression. People with this problem experience varying degrees of anxiety or fear, often starting in childhood, but they usually manage to cover it up and push through. They tend to build their life around one person, become more of a loner over time, have difficulty handling stress or change, and have heightened anxiety symptoms when under more stress.

This constellation of symptoms is often the result of a genetic condition called pyroluria, also known as high mauve, pyrrole disorder, pyrroluria, pyrolleuria, malvaria, and elevated kryptopyrroles.

In Nutrition and Mental Illness, wonderful book written by Carl Pfeiffer in 1987, pyroluria is described as faulty synthesis of heme (a component of hemoglobin, in the blood), resulting in elevated levels of kryptopyrroles (KP) or by-products of hemoglobin synthesis that have no known role in the body. To get quite technical, it turns out that what’s elevated is actually levels of another molecule: hydroxyhemopyrrolin-2-one (HPL). This molecule attaches to zinc and vitamin B6 in the body, which are then excreted in greater amounts than normal in the urine, resulting in deficiencies. Since the body makes 2 million red blood cells per second, you can see how deficiencies can rapidly develop.

Supplementing with zinc and vitamin B6 (and a few other key nutrients) improves the many signs and symptoms of pyroluria. HPL also inhibits synthesis of heme explaining why people with pyroluria often also have low levels of iron or ferritin (the body’s storage form of iron and the first indicator of decreased iron levels) and need to supplement with iron as well.

I cover this in great detail in my book The Antianxiety Food Solution. I devote a whole chapter to it and for simplicity I use the term “pyroluria” in the book, in my blog posts, articles and presentations.

I first learned of pyroluria when I worked with Julia Ross and discovered that I have it. Joan Mathews-Larson covers it in detail in her great book Depression-Free Naturally and I consider her to be a true expert on pyroluria.

It’s not well-recognized in the mental health and medical community. This is the most recent published information on the topic: Discerning the Mauve Factor, Part 1 and Discerning the Mauve Factor, Part 2.

If this sounds like you, here is a link to the Pyroluria Questionnaire from my book. I created this using the work of Carl Pfeiffer and Joan Mathews-Larson, modifying it based on feedback I received from my clients.

Many people are surprised to discover that they now have an answer to something that has plagued them their whole lives.   This was certainly the case with me. Here are Madonna’s results, posted on the pyroluria blog post for the Anxiety Summit season 2: How zinc and vitamin B6 prevent pyroluria and social anxiety

I am 55 and have suffered with panic disorder since age 14. My anxiety has gotten so bad I can hardly leave the house at times. I am a woman of faith but had to even give up church, as I could not handle the people. It has been a rough road. I had already given up gluten and sugar. Somehow I stumbled on the word pyroluria. I did start zinc and b6. Also started primrose oil today. I can tell a difference in my mood and anxiety. I am ready to start living again.

I’d love to see your comments/questions if you can relate to any of this. Also, please do share in the comments if you know you have pyroluria and find the nutrients have eliminated your social anxiety and inner tension symptoms.

 

Rooibos tea with a chocolate twist

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chocolate-rooibos

I’ve discovered a new rooibos tea and love it and want to share it with you! It’s rooibos tea with a chocolate twist: Numi Organic Tea – Chocolate Rooibos with smooth vanilla notes.

When I shared this image on facebook here are two comments I got:

  • I drink Numi’s Rooibos everyday, but I didn’t know they made CHOCOLATE!
  • CHOCOLATE…I’ll have to find that one!

Notice that both people wrote CHOCOLATE in upper case! I have no doubt that the word “chocolate” will get many more people trying this healthy herbal tea. But I must give you an advance warning – the chocolate taste is very subtle. And if you’re sensitive to the caffeine in chocolate like I am you may find you can tolerate this – I certainly can.

You may recall my interview with rooibos researcher, Dr. Amanda Swart, in season 1 of the Anxiety Summit: A Functional Food in the Management of Stress. We discussed the role rooibos plays in the maintenance of normal cortisol levels, the influence of rooibos on cytochrome P450 enzymes, and the amazing array of polyphenols and flavonoids found in rooibos. Wow, a simple beverage that can help reduce stress and anxiety! And so much more!

Here is some new rooibos research:

chocolate-rooibos-description

Just read the description on the back of the box and see if you can resist it:

Smooth South African rooibos is enveloped by creamy vanilla beans, sweet honeybush and rich cacao. This sensual treat is a delightful, soothing beverage you can melt into.

The vanilla gives it a naturally sweet taste which you may need if you don’t enjoy straight rooibos (an acquired taste for some)

Let me give you a few more reasons why I recommend this product – other than the delicious taste and wonderful health benefits:

  • It’s organic
  • It uses fair trade ingredients
  • It uses non-GMO biodegradable tea bags
  • It’s a herbal tea so is caffeine-free
  • It doesn’t have any artificial or even natural flavors

I’m a skier and Brad snowboards and I like to be prepared with “padkos” (South African for food-for-the-road) and one nice treat is hot herbal tea for the drive up and for the drive home. For the trip up to the ski resort, I make it in a large stainless steel mug with lid and we sip it as we drive. I take an extra teabag and a thermos flask of boiling water and make a new batch to sip on the trip home. It’s so yummy and so warming, plus it keeps us well-hydrated which is important with all that exercise. 

Check out the Numi site. I love this company and their vision: “Numi inspires well-being of mind, body and spirit through the simple art of tea. Our company is rooted in the principle of creating a healthful product that nurtures people and honors the planet. In all of our company initiatives, we strive to foster a healthy, thriving global community while bringing you the purest, best-tasting organic tea.”