Digestion and Mental Health - Dr. Leslie · PDF file •Stress can affect digestion at the...

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Transcript of Digestion and Mental Health - Dr. Leslie · PDF file •Stress can affect digestion at the...

  • Leslie Korn, PhD, MPH LMHC, ACS, RPP, NTP, NCBTMB

    Copyright Dr. Leslie Korn, 2018

    Digestion and Mental Health

    Digestion and Mental Health

  • Copyright, Leslie E. Korn, 2018

    Improving digestion

    & nutritional status is

    the missing link to

    mental health

    Poor Digestion is Often Involved in Mental Illness

    Copyright, Leslie E. Korn, 2018

    •Where there is mental illness there is digestive dis-ease • Anywhere along the way there is a bi directional link to stress… Digestion occurs in a parasympathetic state • Chewing & swallowing • Esophagus • Liver • Stomach • Intestines: Small & Large • Elimination

    • Chronic stress ➡ inflammation ➡ depression ➡ self medication behaviors

    Emotional Distress←→Digestive Distress

  • Copyright, Leslie E. Korn, 2018

    • Relaxation • Food quality • Food preparation • Stomach: Hydrochloric acid

    • Liver/GB: Bile

    • Pancreas: Digestive Enzymes

    • Small Intestine: Absorption

    • Large Intestine: Peristalsis & Elimination

    Digestion Requirements

    Copyright, Leslie E. Korn, 2018

    •Digestion is a NORTH to South Process: • Begins in the brain when smells & tastes stimulate saliva. Amylase • Stomach, proteins are worked on by protease • Bolus of food passes into small intestine • Lipase breaks down fats, & amylase finishes off the carbohydrates

    •Most of digestion & absorption takes place in the small intestine • Broken down micronutrients are absorbed pass through the villi in the gut into bloodstream

    • BUT, intestinal permeability torn up sponge

    Digestion Requirements


  • Copyright, Leslie E. Korn, 2018

    • Digestion occurs in a state of relaxation • Stress can slow down or stop the digestive process • Stress wreaks havoc on the digestive system, causing hiccups, heart burn, nausea, diarrhea, & constipation

    • Stress exacerbates the symptoms of digestive disorders like inflammatory bowel disease, stomach ulcers, & celiac


    Digestion & Stress


    Copyright, Leslie E. Korn, 2018

    • Bi directional effect of GERD on depression & anxiety • Stress can affect digestion at the esophageal sphincter • When the sphincter does not close effectively, this allows stomach acid to rise into the lower esophagus,

    causing acid reflux or GERD

    • There are high rates of GERD in people with PTSD suggesting the link between anxiety & GERD

    • Proton pump inhibitors (PPIs) used to decrease acid are associated with severe cognitive decline & dementia

    Digestion, GERD & PTSD


  • Copyright, Leslie E. Korn, 2018

    • Two opposing theories of cause: excess acid & too little acid

    • Eliminate refined carbohydrates sugar & acid foods: coffee/tea (tannins) citrus… all

    relax the sphincter

    • Small meals, mindful chewing, loose clothes • Gentle Abdominal Massage • Ice pack applied to the esophageal sphincter 15 minutes before eating. (At the xyphoid process)

    Digestion, GERD & PTSD


    Copyright, Leslie E. Korn, 2018

    • Eat in places that induce relaxation rather than places where one feels stressed

    • Employ rituals such as communal eating, giving thanks, & potlucks; this can also

    reduce stress & improve digestion

    • Breath slowly & rhythmically before eating & during the meal

    • Eat with others when possible & without the distraction of the TV / computer

    • Put the fork / spoon down between bites & let it sit for 15-30 seconds or more

    Essential Steps for Relaxed Digestion


  • Copyright, Leslie E. Korn, 2018

    • Impaired digestion of protein directly affect

    mood, sleep, & cravings

    • Overuse of antibiotics, along with insufficient

    prebiotics in the diet,

    causes mood problems like

    depression & anxiety

    Digestion & Medications


    Copyright, Leslie E. Korn, 2018 12

    • Theory of mood disorders as primarily based in neurotransmitter (NT) imbalance

    • Multiple influences on mood & cognition of which NT function is only one • Fats, fat metabolism, brain phosphoplipids impairment • Pharmaceutical-grade amino acids address biochemical needs • Provide building blocks that support specific NT production

    We will explore the use of amino acid therapy as a natural approach to antidepressant & anti-anxiety

    Digestion, NTs & Amino Acids

  • Copyright, Leslie E. Korn, 2018

    • Fresh raw plants, sprouts fruits, vegetables, raw honey

    & animal proteins

    •Diet high in cooked foods have few enzymes

    • Aging & medications, reduce enzymes levels

    Digestion & Supplemental Enzymes

    Copyright, Leslie E. Korn, 2018 14

    • Proteolytic enzymes (proteo—lytic) digest protein & inflammation • Amylase: Carbohydrates • Lipase: Fats • Cellulase: Fiber • Maltase: Converts complex sugars from grains into glucose • Lactase: Digest milk sugar (lactose) in dairy products • Phytase: Helps to produce the B vitamins • Sucrase: Digesting most sugars

    • Supplemental Enzymes are a good first step to improve digestion: gas bloating GERD

    Digestion & Supplemental Enzymes

  • Copyright, Leslie E. Korn, 2018 15

    • Refers to toxins & allergens from the GI tract that enter the blood stream

    • Contributes to allergies, autoimmune disorders, & inflammation • Symptoms include abdominal pain, food allergies & intolerances, cognitive & memory problems

    • Leaky gut also increases the risk of alcoholism, autism, ADHD, & multiple food & chemical sensitivities

    (Bland, 2004)

    “Leaky Gut”

    Copyright, Leslie E. Korn, 2018

  • Copyright, Leslie E. Korn, 2018

    • Low dietary fiber, excess of harmful microbiota, alcohol, age, Crohn’s disease, cystic fibrosis, rheumatoid arthritis, atopic eczema, HIV, NSAIDS &


    • Stress • Small Intestinal Bacterial Overgrowth (SIBO) • Gluten protein (gliadin) triggers zonulin, a protein that increases the permeability between cells of the wall of the digestive tract ➔ system wide

    inflammation ➔ neurological, auto immune, & mental health problems (Fasano, 2011)

    Contributors to “Leaky Gut”

    Copyright, Leslie E. Korn, 2018

    • Digestive Process & relationship to mental


    • The First Brain • The Second Brain • Supports for the 1st & 2nd Brain

    Digestion & Mental Health

  • Copyright, Leslie E. Korn, 2018

    • The intestinal tract, or the gut, is called the “second brain”

    • A major source of neurotransmitter production in the body

    • “Second brain” is also known as the enteric nervous system

    • “Second brain” controls the digestive system

    • Bi-directional communication between 1st and 2nd brain

    The Second Brain: The Microbiome

    Copyright, Leslie E. Korn, 2018

    • A long system of hollow organs that are joined together, creating an unbroken tube that begins

    at the mouth & ends at the anus

    • The mouth, esophagus, stomach, small intestine, large intestine, rectum, & anus

    • The liver, gallbladder, & pancreas • Solid organs that play essential roles in the digestion of food

    Gastrointestinal (GI) Tract


  • Copyright, Leslie E. Korn, 2018

    • Controls the break down & absorption of foods, eliminates waste

    • The rhythms of peristalsis that move food along the digestive tract

    • Transforms food into chemical messengers, (neurotransmitters) that

    support emotional & cognitive life

    • Bacteria support NT’s that help regulate brain function

    • Gardening & the dirt bacteria are anti depressants!

    The Second Brain & Digestion


    (Lowry et al., 2007, Neuroscience)

    Copyright, Leslie E. Korn, 2018

    How Food Nourishes Your Brain, Mind & Emotions

  • Copyright, Leslie E. Korn, 2018

    • Eat only when relaxed • Incorporate rituals of mindfulness before meals • Chew food until it is almost liquid • Reduce or eliminate medications that impair hydrochloric acid function • Ensure sufficient digestive enzymes • Identify each organ of digestion & ensure it is working well • Treat gut permeability • Eat a variety of prebiotic foods including soluble & insoluble fibers • Eat a variety of probiotic “fermented” foods • Follow food combination principles for better digestion

    Essential Steps to Nourish the Second Brain

    Copyright, Leslie E. Korn, 2018

    • Different for everyone & based on individual “biochemistry” • Essential during times of stress because protein supports growth & repair in the body, which tends to break down under stress

    • Increase if one is doing vigorous exercise •Women generally need less protein than men •Must be easily assimilated • Alcohol & drug recovery: start simple broth