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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by jrbecker on May 25, 2004, at 13:29:50
courtesy of McMan's Depression and Bipolar Web
http://www.mcmanweb.com/article-13.htm
You Are What You Eat
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A 2003 issue of Time International reports on 41-year-old Amanda Jodhpuria, who had bad luck with lithium, and sought out a nutritionist who diagnosed a B vitamins and fatty acids deficiency, which prompted her to change her diet - no coffee, sugar, or salt, and more fish. She told Time: "My mood has leveled out, and the depressions are much shorter." The same article reports a survey from the British mental health group, Mind, which found that 80 percent of those who followed a diet low in sugar, caffeine, chocolate, and alcohol and high in water, vegetables, fruit, and oil-rich fish reported improved moods, with 26 percent citing major improvements.
Scientists are coming up with new findings all the time now. For starters, there are clear connections between mood and foods rich in folates (green leafy vegetables). Researchers at Harvard confirmed recent studies that show: 1) a link can be made between folate deficiency and depressive symptoms, and 2) that low folate levels can interfere with the antidepressant activity of the SSRIs on the brain's neurotransmitters. A Tufts University study of nearly 2,948 individuals found that those who met the criteria for a lifetime diagnosis of major depression had lower serum and red blood folate concentrations than those who had never been depressed. Those with dysthymia had lower red blood cell folate only. The authors of the study recommend folate supplementation during the year following a depressive episode. (See article for more on nutritional supplements.)
An eight-week Harvard study of 322 outpatients with major depression on 20 mg/day of Prozac found that those with high cholesterol levels were "significantly more likely" not to respond to the drug than patients with low cholesterol.
Over-eating
At the 2003 Depression and Bipolar Support Alliance conference, Diana Lipson-Burge, a nutrition consultant and co-author of "Undieting", cautioned that 80 percent of the dieting information out there is inaccurate, especially the gimmick diets found in just about every magazine. Ironically, dieters are told to consult a doctor who typically has had only one nutrition class in med school. Not surprisingly, according to one 10-year study, there is only a 5.2 percent success rate with diets.
This is what it takes to form one pound of fat: The average person burns 1,300 calories a day just to stay in bed. This is called the basal metabolic weight. An additional 600 calories are burned, on an average day, for getting out of bed and moving around, resulting in 1,900 calories to maintain natural body weight. One would have to consume 3,500 calories more on top of that in one day to add a pound of fat, which is almost impossible (disregarding meds and other exceptions). Even binge eaters, said Ms Lipson-Burge, don’t eat that much. Rather, the process is far more gradual.
Coming at it from the other end, if you lose five pounds in one week, four of the pounds are bound to be water.
Throw away your scale, Ms Lipson-Burge urged, and listen to your stomach. The stomach, she explained, works like a gas gauge on a car. On a one to 10 scale, two corresponds with a growling sensation in the stomach, when all that’s left of a previous meal is a thin lining on the stomach wall. X-rays have shown that infants and toddlers (who instinctively know how to eat right) and fit adults start eating when the stomach is at two.
This contrasts with the "it’s lunchtime I must be hungry" mentality.
The fit eaters always stopped eating at seven on the "stomach gauge," with no pressure on the stomach wall.
The stomach only holds glucose for about three to four hours (all food is turned into glucose for energy). According to Ms Lipson-Burge, you should be at a two at about then, which is a good sign you ate the right type and amount of food.
Compensating for overeating by fasting tends to backfire. If you get down to a zero on the stomach gauge, Ms Lipson-Burge warned, the body will think it’s in a diabetic coma, resulting in food cravings that don’t stop until the stomach is overfilled.
Any program that recommends cutting out certain food groups such as carbs, should be regarded as suspect, no matter how many pounds the person in the next cubicle has shed.
Toxic foods
Some people can't eat wheat, others are sensitive to the artificial sweetener aspartame, either of which can alter mood. The list goes on and on and on.
Patients can take food allergy tests, though they are expensive and their reliability has been called into question. A more labored but failsafe means, she says, would be to eliminate a suspect food from one’s diet to see what happens. These would include: dairy, wheat, corn, eggs, citrus, caffeine, alcohol, refined sugar, honey, maple or barley syrup, tap water, or any food one eats more than three times a week.
One is advised to read labels carefully, as hidden allergens are frequently found in packaged foods.
An article by John Stegmaier on the New Hope Foundation website reports of Illinois psychiatrist Thomas Stone MD who is committed to seeking out any food sensitivities that may be causing or contributing to an individual’s mental problems. New patients are put on a strict spring water fast for several days, then tested one food at a time for psychological reactions while being monitored for pulse and other functions. John’s 23-year-old daughter, who had endured nine years of failed treatments, erupted into a psychotic episode after eating a test course of brussels sprouts. The article fails to report his daughter’s outcome, which was presumably for the better, but does mention he and his wife got the cold shoulder from the honchos at NIMH when they tried to pass on the good news.
The average American eats more than 125 pounds of white sugar a year, comprising 25 percent of our daily calorie intake. According to Rita Elkins MH in Solving the Depression Puzzle, (Woodland Publishing, 2001): "We have become obsessed with sugar, not fully recognizing what excessive sugar consumption not only does to the body, but also the mind. Sugar is a powerful substance that can have a druglike effect, and it is considered addictive by a number of nutritional experts. In fact, excess amounts of sugar can be toxic." (See article.)
If you think you can cheat by going to a sugar substitute, think again. Many people are particularly sensitive to aspartame, and Ralph Walton MD, a professor in clinical psychiatry at Northeastern Ohio Universities College of Medicine, argues people with mood disorders are at special risk (see article). I am conditionally using Splenda, at least until I hear something bad about it. One measure of Splenda is supposed to equate with one measure of sugar, but I'm finding Splenda to be twice as strong.
According to Diana Lipson-Burge, carbs release serotonin to the brain, which is why we crave the stuff. But we’re not addicted to carbs, as we would just be eating sugar. You’re addicted to the serotonin, she stressed.
Carbs are the first thing your body turns to for energy. Simple carbs include sugar and white flour while complex carbs include fruit and vegetables. To avoid sugar crashes, says Ms Lipson-Burge, one needs to buffer carbs with proteins and fat, say 40-50 percent carbs to 20 percent protein and 20 to 30 percent fat. Think bagel with eggs or egg beaters.
In the 1990s, food experts came up with the glycemic index to show how some foods raised blood sugar higher than others, but which failed the stupid test by not accounting for the total carbohydrates in a particular food. Thus carrots equated to sugar and potatoes to hard candy. A team from Harvard University then developed the glycemic load, derived by multiplying a food’s glycemic index by grams of carbs in a serving of food. Using glycemic load as an index, carrots are restored to good standing, and potatoes conditionally so.
The glycemic load affirms what most of us already knew: Opt for brown rice over white rice, enriched pastas over plain ones, peasant breads over white and whole wheat (commercial whole wheat and dark breads are basically white bread with coloring), fresh fruit over commercial fruit juice (which is basically sugar water), oatmeal over corn flakes, whole grains over processed grains, plenty of beans and vegetables.
Restoring the Messed-Up Food Chain
A 2003 review article in the International Journal of Circumpolar Health by biologist Able Bult-Ito and associates of the University of Alaska, Fairbanks offers an excellent case study on what happens when various populations change from their traditional means of procuring and consuming food to steak and Crisco and a lot of junk.
Though the traditional diets of circumpolar people vary from region to region, the menu generally draws from marine mammals, fish, hoofed animals, fur-bearing animals, birds and their eggs, plants, and berries. These foods are rich in nutrients, with high levels of protein, omega-3 fatty acids, and antioxidants, while low in carbohydrates. Until contact with westerners, obesity, diabetes, and cardiovascular disease were virtually unknown to the frozen north. That changed with the introduction of a western diet, which is high in carbs and saturated fats and low in essential nutrients such as omega-3. Bad physical and dental health followed like six-month night after six-month day. Mental health also headed south as a result, contend the authors of the article.
Omega-3 is crucial to neuronal and brain development, function, and health, and is available from fish, grass-fed mammals, and certain plants. Lower levels of fish consumption and omega-3 have been linked to increased rates of depression and possibly suicide. Deficiencies in omega-3 can affect serotonin and dopamine transmission in the frontal cortex and hippocampus (see article for more on omega-3 supplements).
Studies have found that rates of depression, seasonal affective disorder, seasonality, anxiety, and other mental illnesses are on the rise in circumpolar regions, especially among non-isolated populations. Suicide rates have increased seven-fold in many northern populations over the past several decades. The suicide rate for the Canadian Inuit from 1987 to 1991 was 3.9 times higher than that of the general Canadian population.
The authors of the article acknowledge that the mental distress of the Inuit and their brethren can be attributed to social, cultural, and lifestyle upheaval, as well as increases in chronic physical diseases, but they argue that "the combined decline in mental health and the disappearance of traditional diets in circumpolar peoples makes a direct connection between diet and mental health in these people a very real possibility."
Before you go out and buy salmon to load up on omega-3, be advised that the salmon you find in most outlets is farm-raised and fed on grain, which does not contain omega-3, plus fish meal to artificially boost omega-3, but to nowhere the levels found in more expensive ocean-caught salmon, where the omega-3 travels up the food chain from algae. According to the FDA, salmon has low mercury concentrations compared to some other types of fish, and should be considered safe when eaten in moderation. Oysters, whitefish, sea bass, freshwater trout, and sardines are also high omega-3-low mercury sources. Fresh tuna and more expensive canned and albacore tuna contain nearly the same amount of omega-3 as salmon, but three times as much mercury, while canned light tuna is low in omega-3 and mercury. A two-ounce serving of canned albacore, according to one manufacturer, has 2.2 grams of omega-3.
Carnivores may want to consider switching to grass-fed beef, which is much higher in omega-3 and lower in saturated fats than the grain-fed, hormone-injected marbled slabs that end up on our tables. Grain-fed beef has a 20 to one ratio of omega-6 to omega-3, while grass-fed beef is about three to one. The ideal diet is considered to comprise equal parts omega-3 and omega-6. New Zealand and Australian beef come from grass-fed cattle, as do certain meats from various parts of Europe. US producers are beginning to fill a high-priced niche, and buffalo is another option. The French feel their organically raised Charolais and Limousin cattle superior in taste to grain-fed US Angus, but for grass-fed beef in general there tends to be a sacrifice in taste and texture, though a good cook will relish this as a culinary challenge.
Eating Smart
Fortunately, one can eat smart with little sacrifice to old habits and good taste. Preparing dishes yourself allows you considerable control over what goes into your system. That "heart attack on a plate" served up by a restaurant or in a frozen food package can be a very healthy and tasty dish when prepared yourself with different ingredients. Eating "low fat" or "no fat" plus a dish you like will bring up dozens of recipes on Google. A few tricks I have picked up over the years:
1. Smart cheese: Cheese on a beef burger is an invitation to a heart attack. Cheese on a turkey burger or a veggie burger makes you forget it's not beef. If you can stomach the low fat cheese, so much the better. A light sprinkling of grated cheese also does wonders for otherwise bland dishes such as white fish. For pizza, put tomato sauce and a little olive oil on a store-bought crust, and go lightly on the cheese - go for Parmesan or Romano where a little goes a long way.
2. Ground turkey: Use this in pasta sauce, lasagna, and chili instead of ground beef, and you won't know the difference. For a burger, you need to spice it up and add barbecue sauce as well as an egg to bind. Ground turkey also makes a good meatloaf. For those of you lucky enough to live in places like New Zealand where they don’t meddle with the food chain, you can beef it up to your heart’s content. The rest of us need to eat beef sparingly or find beef from grass-fed cattle.
3. Fat-free hotdogs: There is no significant taste difference. Fat-free sausages are another story, but the 1/2 fat is a good compromise.
4. Smart meat: Meat should be part of an ensemble production rather than a star vehicle. That way you eat less of it. This means meat and pasta, meat and rice (Chinese, Indian, paella, gumbo, Cajun, etc), meat and beans (Mexican), meat with rice and beans (Latino), meat and couscous (Middle East), meat and veggies (Chinese, etc). If you must use cheese or sour cream, use less of it and go for low fat.
5. Low fat versions: Most foods these days come in no fat or low fat versions. Much of the no fat involves considerable sacrifice in taste and texture, but not so much with low fat.
6. Smart sauces: Go with stock-based rather than cream-based sauces. A little cheese in stock gives it a creamy texture. If you must opt for cream, use low fat or no fat half and half.
7. Watch out for the little things: It's the extras that can do you more harm than the main course. Poultry stuffing cooked in the bird is soaked with fat - cook it in a separate dish with stock. Count to ten before you reach for that guacamole for your fajitas.
8. Smart desserts and comfort foods: You won't miss the fat in no fat crackers. There is no substitute for Ben and Jerry's, but low fat or no fat ice cream and frozen yogurt won't make you feel a Somalia poster child, either. It is human nature to desire the full range of comfort foods and desserts. You don't need to deprive yourself. Simply eat less of them, or the low-fat versions - and don't keep too many supplies in the house.
9. Smart oil: Use olive oil, canola oil, or other vegetable oils with "good" fats.. Avoid cooking fats that are solid at room temperature. Buy natural peanut butter with the oil in its natural liquid form rather than the death-defying commercial compounds.
10. Finally, you’re entitled to occasional indulgences.
For three free online issues of McMan's Depression and Bipolar Weekly, email me and put "Sample" in the heading and your email address in the body.
Updated April 29, 2004
Posted by octopusprime on May 25, 2004, at 22:29:15
In reply to You Are What You Eat - article from McMan's Web, posted by jrbecker on May 25, 2004, at 13:29:50
i loved this quote:
"John’s 23-year-old daughter, who had endured nine years of failed treatments, erupted into a psychotic episode after eating a test course of brussels sprouts. "i always knew brussel sprouts were poison! now i have a good excuse. thanks :)
although i think i would be more depressed if i was deprived of coffee!
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Dr. Bob is Robert Hsiung, MD,
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