Neurotransmitter imbalance: When neurotransmitters are present in sufficient amounts, mood and emotions are stable. When they are depleted, or out of balance, individuals may overeat (particularly sweet and starchy foods) or starve simply to try to manage mood.69
In eating disorders, there may be a particular link to disturbed serotonin metabolism. Serotonin is a neurotransmitter that plays a role in controlling carbohydrate intake, promoting sleep, and managing impulsive and obsessional behaviors. Serotonin is made from tryptophan, an amino acid found in foods such as milk, cottage cheese, poultry, turkey and chicken, eggs, red meat, soybeans, tofu, and almonds. vitamin B6, zinc, and insulin are also needed for serotonin production. Chapter 28 explains how to promote serotonin through nutrition and lifestyle changes.
Dieting has been shown to deplete levels of tryptophan very quickly, particularly in women.70 In one study, when bulimics were deprived of tryptophan, their serotonin levels dropped and they binged on an average of nine hundred additional calories each day.71 This led to a large increase in serotonin production and release within the brain, temporarily reducing stress and depression. However, the serotonin “fix” was followed by overwhelming feelings of guilt and low self-esteem, triggering the powerful need to purge. Vomiting also depresses serotonin levels as the body loses the essential nutrients needed to make serotonin.
Low serotonin may also give rise to some of the personality traits commonly seen with bulimia—depression, impulsiveness, irritability, and mood swings. One further study showed that even years into recovery, bulimics can have a return of their cravings and mood problems after only a few hours of tryptophan depletion.72
Hormone imbalances: The sex hormones estrogen, progesterone, and testosterone interact with neurotransmitters to stimulate many of the brain’s mood sites. Low estrogen has been linked to low serotonin and an increase in cravings. Low progesterone can lead to infertility, anxiety, and PMS, while too much can lead to lethargy, increased appetite, weight gain, and depression—common symptoms in people with eating problems.
An eating disorder places considerable stress on the body and on the adrenal glands, which are responsible for producing most of the stress hormones. Adrenal stress can easily disrupt other hormones, particularly in the thyroid and the ovaries. Where the diet is low in good-quality protein (for instance, in some vegetarian and vegan diets), the risk of adrenal exhaustion may be even greater owing to a lack of amino acids for hormone production. Vegetarianism is much more common in those with eating disorders (particularly anorexia nervosa) than in the general population.
Food allergies and intolerances: Certain foods may have a mood-altering effect in some people; for instance, refined carbohydrates and sugar impact serotonin and endorphin production, increase blood sugar, and stress the adrenal glands. Wheat (plus rye, oats, and barley) contains gluten, which can interfere with the absorption of nutrients and affect neurotransmitter production and thyroid function. People with gluten intolerance may also be low in serotonin and this may give rise to depression. Casein, a milk protein found in dairy products, and lactose, a milk sugar, may also result in similar problems. Soy can depress thyroid function because its phytate content blocks the uptake of iodine and the absorption of thyroid hormones. Low thyroid function in people who binge eat may contribute to weight gain or obesity.
Deficiency of essential fatty acids: People with eating disorders are often “fat phobic.” Low-fat diets have been associated with depression and irritability partly because essential fats are crucial for brain function and for the production of sex and stress hormones. Blood sugar levels can also drop very rapidly in the absence of fat.
Gastrointestinal disturbance: A diet high in sugars and refined carbohydrates may result in yeast overgrowth in the gut. This can contribute to constipation, bloating, slow gastric emptying, and malabsorption, as well as to mental and emotional symptoms. The mechanisms and hormones that control hunger and fullness can also be disrupted.
Optimum nutrition for eating disorders
There have always been differing views as to whether nutritional approaches or psychological treatments hold the key to successful recovery from an eating disorder. Although more research is needed into the efficacy of nutritional approaches, there appears to be growing recognition that the disorders do have nutrition-related aspects and that approaches combining both nutritional and psychological treatment may offer the best possibility for recovery.73
It must, however, be remembered that eating disorders are complex mental health conditions with potentially serious consequences. Care must include psychological treatments, regular medical monitoring, and possibly medication. Nutritional counseling should not be offered as a sole treatment, but it may form part of a multidisciplinary approach. Hospitalization should be considered where people do not respond to outpatient treatment, if weight is very unstable or extremely low, if there are serious physical complications, or if there is risk of suicide.
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Mental Health—The Nutrition Connection
Life in the twenty-first century is stressful. Some of us are rising to the challenge, but most of us are struggling to keep up and are living with tiredness, anxiety, stress, depression, and sleeping problems as a result. Some people tip over the edge into mental health problems—from attention-deficit disorder to Alzheimer’s disease and schizophrenia. In fact, the world over, there’s been a massive increase in the incidence of mental health problems, especially among young people. The incidences of autism, suicide, violence, and depression are on the increase, according to the World Health Organization. Mental health problems, they say, are fast becoming the number one health issue, with one in ten people suffering at any point in time, and one in four people suffering at some point in their lives.74
If you’ve got a strange set of physical symptoms, your doctor is probably going to run a basic biochemical screening blood test to see if anything abnormal shows up. The same is rarely done for those with mental health problems, as the belief is that biochemical imbalances don’t manifest as psychological symptoms. Of course, the reverse is true. The brain is far more sensitive to biochemical imbalances and nutritional deficiencies than any other organ of the body.
The very fact that most treatment of mental illness involves chemical drugs is an indication of the direct link between a person’s biochemical state and their psychological state. We also know that deficiencies in nutrients, and excesses in “antinutrients” such as lead or chemical additives, can cause mental health symptoms.
There’s more to it than that, however. Having worked with thousands of people with mental health problems, I’m convinced that most have one, or more, of a combination of thirteen common biochemical imbalances that if left untreated can lead to mental illness.
So, if you do have mental health problems, it is well worth checking out these imbalances, each of which has a clear set of symptoms. If you have some or all of the symptoms, then an objective biochemical test can be run to confirm whether or not this imbalance is present. Then, a nutritional strategy can be implemented to help solve the problem.
A new diagnosis of mental health problems
The diagnosis of mental health problems should be based on the observation of symptoms, objectively measured in questionnaire tests, and on physical and biochemical tests that help determine if any of the many kinds of biochemical imbalances are causing, or contributing to, a person’s problems. Here are some of the more common biochemical imbalances that can result in symptoms of mental illness.
1. Blood sugar imbalance
The most common underlying imbalance in many types of mental health problems is fluctuating blood sugar levels, called dysglycemia. If you’ve got this, the chances are you crave sweet foods or stimulants such as tea, coffee, and cigarettes, all of which affect your blood sugar level. Here are the most common symptoms:
Difficulty concentrating
Heart palpitations
Fainting, dizziness, or trem
bling
Excessive sweating or night sweats
Excessive thirst
Chronic fatigue
Frequent mood swings
Forgetfulness or confusion
Tendency to depression
Anxiety and irritability
Feeling weak
Aggressive outbursts or crying spells
Cravings for sweets or stimulants
Drowsiness after meals
If you’ve got five or more of these symptoms, you are likely to have dysglycemia. The best way to confirm this is by a blood test that measures “glycosylated hemoglobin.” As more and more people are becoming dysglycemic, the incidence of related conditions such as obesity, age-related memory loss, Alzheimer’s disease, heart disease, and diabetes is also on the increase.
Here are a few simple steps you can take to help balance your blood sugar:
Avoid sugar and foods containing sugar.
Break your addiction to caffeine by avoiding coffee, tea, and other caffeinated drinks for a month, while improving your diet. Once you are no longer craving caffeine, the occasional cup of weak tea and very occasional coffee is not a big deal.
Break an addiction to chocolate, if you have one.
Always have something substantial for breakfast, such as an unrefined oat-based cereal; unsweetened live yogurt with banana, ground sesame seeds, and wheat germ; or an egg.
Eat a high-fiber diet rich in fresh vegetables and fruit. Fiber helps keeps your blood sugar level even.
Certain vitamins and minerals can help regulate your blood sugar level and minimize the withdrawal effects of stimulants. These include vitamin C, vitamin B complex, especially vitamin B6, and the minerals magnesium and chromium.
2. Stimulant and drug dependence
Although many people know that drinking and eating stimulants is not good for their health, it is not assumed that it can make them crazy. This is far from the truth. Excessive intake of stimulants (tea, coffee, alcohol, sugar, cola, caffeine pills, cigarettes) can bring on symptoms of mental illness. The symptoms are very similar to those for dysglycemia, coupled with cravings for any of these substances. In addition, you can experience extreme anxiety, paranoia, and depression through the excessive use of some of these substances. Complete the stimulant inventory in chapter 11 and take the necessary steps to reduce your stimulant load.
3. Food and chemical allergies and intolerances
If you suffer from daily mood swings, or are fine at some times and not at others for no apparent reason, one possibility is that you are reacting to something you’re eating. The most common single food that’s been linked to mental health problems is wheat, which is a rich source of gluten. Other foods that can cause allergic reactions include milk products, oranges, eggs, grains other than wheat, foods with yeast, shellfish, nuts, beef, pork, and onions. Food colorings such as tartrazine and other chemical additives can also cause problems. Some people develop intolerances to tea and coffee, while alcohol, which irritates the gut wall and makes it more leaky, often increases allergic sensitivity to anything eaten. Check yourself out on the symptoms below:
Childhood history of colic, eczema, asthma, rashes, or ear infections
Daily mood swings
Deep depressions for no particular reason
Frequent, rapid colds or blocked nose
Difficulty sleeping
Facial puffiness, circles or discoloration around the eyes
Hyperactivity
Dyslexia or learning difficulties
Aggressive outbursts or crying spells
If you score five or more, or know you feel better when you avoid certain foods, then food or chemical allergies/intolerances may be contributing to your problem. The best advice is to see a nutritional therapist, who can show you how to do a two-week avoidance-and-reintroduction test with your suspect foods. Alternatively, have a quantitative IgG ELISA allergy test using a simple home test kit (see Resources). This involves a pinprick of blood from which you can be tested for allergy to over a hundred different foods and chemicals.
4. Underactive or overactive thyroid
If your mind and body feel sluggish most of the time, you may have an underactive thyroid, referred to as hypothyroidism. If your thyroid is clinically underactive, your doctor may prescribe thyroid hormones. However, blood tests are often unable to detect subclinical hypothyroidism, so it may be better to go by the symptoms. You can test your thyroid function yourself with the Broda Barnes temperature test. If your temperature before you rise in the morning is consistently below 97.7°F, this suggests your thyroid may be underactive. Below are the typical symptoms of hypothyroidism:
Physical or mental fatigue or lethargy
Depression or irritability
Dry skin and/or hair
Intolerance to cold or cold hands and feet
Constipation, gas, bloating, or indigestion
Weight gain
Painful periods
Muscle pain
Poor memory
Sore throat or nasal congestion
If you score five or more, an underactive thyroid may be contributing to your problem. Get it tested by your doctor and also see a nutritional therapist, who can show you which foods to eat and which foods to avoid to support your thyroid. Chronic stress can deplete thyroid function, as the stress hormone, Cortisol, inhibits it. Thyroid health is also dependent on specific nutrients in the diet, most importantly iodine—which is abundant in seafood and seaweed—zinc, selenium, and tyrosine, an amino acid found in all protein-rich foods.
Having an overactive thyroid can lead to mania, overactivity, and a fast metabolism, so it is not common for people with this condition to be overweight. If these symptoms are present, ask your doctor to check your thyroid function.
5. Niacin (B3), pyridoxine (B6), folic acid, or B12 deficiency
These four B vitamins are your brain’s best friends. They “oil the wheels” of the brain’s neurotransmitters, especially dopamine, adrenaline, noradrenaline, and serotonin. These neurotransmitters are the brain’s chemicals of communication, sending messages from one brain cell to another. Without enough of these essential B vitamins, the brain can produce chemicals that make you feel crazy. This is because they help control methylation, a chemical process that goes on throughout the brain and body, helping to turn one neurotransmitter into another. Some people need a lot more B vitamins than others, so it’s best to be guided by symptoms, rather than by blood tests. Here are the more common symptoms of a deficiency in these vitamins:
Feeling “unreal”
Hearing your own thoughts
Anxiety and inner tension
Inability to think straight
Suspicion of people
Good pain tolerance
Seeing or hearing things abnormally
Having delusions or illusions
Loose bowels or skin problems at onset of mental health problems
Difficult sexual orgasm
Tendency to gain weight
Frequent mood swings
If you have five or more of these symptoms, it may be worth your while increasing your intake of these nutrients for two months. As a recommendation try 100 mg of B3, 100 mg of B6, 1,000 mcg of folic acid, and 100 mcg of B12.
6. Essential fatty acids—deficiencies and imbalances
Your brain is 60 percent fat, if you take out all the water. This fatty tissue needs replenishing, but it’s crucial to know which fats will feed your brain the best. Essential fatty acids known as omega-3 and omega-6 are intimately involved in brain function, and deficiencies or imbalances in brain fats are now known to be associated with everything from dyslexia, hyperactivity, and depression, to schizophrenia and manic depression.
Most authorities agree that of our total fat intake, no more than one-third should be saturated (hard) fat, and at least one-third should be polyunsaturated oils providing the two essential fats omega-3 and omega-6. These two essential fats also need to be roughly in balance�
��in other words 1:1, which is the ratio our pre-industrial revolution ancestors achieved. Nowadays, an average balance is more like 1:20 in favor of omega-6. It may not be just gross deficiency in these fats, but also the gross imbalance between the two types, that is contributing to the mental and other health problems we see today.
Why is the modern diet likely to be more deficient in omega-3 fats than in omega-6? It’s all because the grandmother of the omega-3 family, alpha-linolenic acid, and her metabolically active grandchildren EPA (eicosapentaenoic acid) and DHA (docasahexaenoic acid), are more unsaturated and so more prone to damage by cooking, heating, and food processing. In fact, the average person today eats a mere one-sixth of the omega-3 fats found in the diets of people living in 1850. This decline is partly due to food choices, but mainly to food processing.
In short, it is important to assess your need for essential fats if you have a mental health problem. Common symptoms of deficiency or imbalance include:
Excessive thirst
Chronic fatigue
Dry or rough skin
Dry hair, loss of hair, or dandruff
Premenstrual syndrome (PMS) or breast pain
Eczema, asthma, or joint ache
Dyslexia or learning difficulties
Hyperactivity
Depression or manic depression
Schizophrenia
If you have five or more of these symptoms and you have a mental health problem, it might be a good idea to have a blood test to determine your essential fat status. The best foods for brain fats are:
Omega-3: flaxseeds, hemp seeds, pumpkin seeds, walnuts, salmon, mackerel, herring, sardines, anchovies, tuna, and eggs.
The New Optimum Nutrition Bible Page 35