Download - Digestion and Mental Health - Dr. Leslie Korndrlesliekorn.com/wp-content/uploads/2018/06/05_Digestion_PPT_Ret… · •Stress can affect digestion at the esophageal sphincter •When

LeslieKorn,PhD,MPHLMHC,ACS,RPP,NTP,NCBTMB

CopyrightDr.LeslieKorn,2018

Digestion and Mental Health

Digestion and Mental Health

Copyright,LeslieE.Korn,2018

Improvingdigestion

&nutritionalstatusis

themissinglinkto

mentalhealth

Poor Digestion is Often Involved in Mental Illness


•Wherethereismentalillnessthereisdigestivedis-ease

• Anywherealongthewaythereisabidirectionallinktostress…Digestionoccursinaparasympatheticstate• Chewing&swallowing• Esophagus• Liver• Stomach

• Intestines:Small&Large

• Elimination

• Chronicstress➡inflammation➡depression➡selfmedicationbehaviors

Emotional Distress←→Digestive Distress


• Relaxation• Foodquality• Foodpreparation• Stomach:Hydrochloric

acid

• Liver/GB:Bile

• Pancreas:DigestiveEnzymes

• SmallIntestine:

Absorption

• LargeIntestine:Peristalsis&Elimination

Digestion Requirements


•DigestionisaNORTHtoSouthProcess:• Beginsinthebrainwhensmells&tastesstimulatesaliva.Amylase

• Stomach,proteinsareworkedonbyprotease

• Bolusoffoodpassesintosmallintestine

• Lipasebreaksdownfats,&amylasefinishesoffthecarbohydrates

•Mostofdigestion&absorptiontakesplaceinthesmallintestine

• Brokendownmicronutrientsareabsorbedpassthroughthevilliinthegutinto

bloodstream

• BUT,intestinalpermeabilitytornupsponge

Digestion Requirements

6


• Digestionoccursinastateofrelaxation• Stresscanslowdownorstopthedigestiveprocess• Stresswreakshavoconthedigestivesystem,causing

hiccups,heartburn,nausea,diarrhea,&constipation

• Stressexacerbatesthesymptomsofdigestivedisorders

likeinflammatoryboweldisease,stomachulcers,&celiac

disease

Digestion & Stress

7


• BidirectionaleffectofGERDondepression&anxiety• Stresscanaffectdigestionattheesophagealsphincter• Whenthesphincterdoesnotcloseeffectively,this

allowsstomachacidtoriseintotheloweresophagus,

causingacidrefluxorGERD

• TherearehighratesofGERDinpeoplewithPTSDsuggestingthelinkbetweenanxiety&GERD

• Protonpumpinhibitors(PPIs)usedtodecreaseacidare

associatedwithseverecognitivedecline&dementia

Digestion, GERD & PTSD

8


• Twoopposingtheoriesofcause:excessacid&toolittleacid

• Eliminaterefinedcarbohydratessugar&

acidfoods:coffee/tea(tannins)citrus…all

relaxthesphincter

• Smallmeals,mindfulchewing,looseclothes

• GentleAbdominalMassage

• Icepackappliedtotheesophagealsphincter15minutesbeforeeating.(Atthexyphoidprocess)

Digestion, GERD & PTSD

9


• Eatinplacesthatinducerelaxationratherthanplaceswhereonefeelsstressed

• Employritualssuchascommunaleating,

givingthanks,&potlucks;thiscanalso

reducestress&improvedigestion

• Breathslowly&rhythmicallybeforeeating

&duringthemeal

• Eatwithotherswhenpossible&withoutthedistractionoftheTV/computer

• Putthefork/spoondownbetweenbites&letitsitfor15-30secondsormore

Essential Steps for Relaxed Digestion

10


• Impaireddigestionof

proteindirectlyaffect

mood,sleep,&cravings

• Overuseofantibiotics,alongwithinsufficient

prebioticsinthediet,

causesmoodproblemslike

depression&anxiety

Digestion & Medications

11


• Theoryofmooddisordersasprimarilybasedinneurotransmitter(NT)

imbalance

• Multipleinfluencesonmood&cognitionofwhichNTfunctionisonlyone

• Fats,fatmetabolism,brainphosphoplipidsimpairment

• Pharmaceutical-gradeaminoacidsaddressbiochemicalneeds

• ProvidebuildingblocksthatsupportspecificNTproduction

Wewillexploretheuseofaminoacidtherapyasanaturalapproachtoantidepressant&anti-anxiety

Digestion, NTs & Amino Acids


• Freshrawplants,sproutsfruits,vegetables,rawhoney

&animalproteins

•Diethighincookedfoodshavefewenzymes

• Aging&medications,reduce

enzymeslevels

Digestion & Supplemental Enzymes


• Proteolyticenzymes(proteo—lytic)digestprotein&inflammation

• Amylase:Carbohydrates

• Lipase:Fats• Cellulase:Fiber• Maltase:Convertscomplexsugarsfromgrainsintoglucose

• Lactase:Digestmilksugar(lactose)indairyproducts

• Phytase:HelpstoproducetheBvitamins

• Sucrase:Digestingmostsugars

• SupplementalEnzymesareagoodfirststeptoimprovedigestion:gasbloatingGERD

Digestion & Supplemental Enzymes


• Referstotoxins&allergensfromtheGItractthatentertheblood

stream

• Contributestoallergies,autoimmunedisorders,&inflammation

• Symptomsincludeabdominalpain,foodallergies&intolerances,

cognitive&memoryproblems

• Leakygutalsoincreasestheriskofalcoholism,autism,ADHD,&

multiplefood&chemicalsensitivities(Bland,2004)

“Leaky Gut”



• Lowdietaryfiber,excessofharmfulmicrobiota,alcohol,age,Crohn’s

disease,cysticfibrosis,rheumatoidarthritis,atopiceczema,HIV,NSAIDS&

antibiotics

• Stress• SmallIntestinalBacterialOvergrowth(SIBO)

• Glutenprotein(gliadin)triggerszonulin,aproteinthatincreasesthepermeabilitybetweencellsofthewallofthedigestivetract➔systemwide

inflammation➔neurological,autoimmune,&mentalhealthproblems

(Fasano,2011)

Contributors to “Leaky Gut”


• DigestiveProcess&relationshiptomental

health

• TheFirstBrain• TheSecondBrain• Supportsforthe1st&2ndBrain

Digestion & Mental Health


• Theintestinaltract,orthegut,iscalledthe“secondbrain”

• Amajorsourceofneurotransmitter

productioninthebody

• “Secondbrain”isalsoknownastheentericnervoussystem

• “Secondbrain”controlsthedigestivesystem

• Bi-directionalcommunicationbetween

1stand2ndbrain

The Second Brain: The Microbiome


• Alongsystemofholloworgansthatarejoined

together,creatinganunbrokentubethatbegins

atthemouth&endsattheanus

• Themouth,esophagus,stomach,small

intestine,largeintestine,rectum,&anus

• Theliver,gallbladder,&pancreas• Solidorgansthatplayessentialrolesinthedigestionoffood

Gastrointestinal (GI) Tract

20


• Controlsthebreakdown&absorptionoffoods,eliminateswaste

• Therhythmsofperistalsisthatmove

foodalongthedigestivetract

• Transformsfoodintochemical

messengers,(neurotransmitters)that

supportemotional&cognitivelife

• BacteriasupportNT’sthathelpregulatebrainfunction

• Gardening&thedirtbacteriaareantidepressants!

The Second Brain & Digestion

21

(Lowryetal.,2007,Neuroscience)


How Food Nourishes Your Brain, Mind & Emotions


• Eatonlywhenrelaxed• Incorporateritualsofmindfulnessbeforemeals

• Chewfooduntilitisalmostliquid

• Reduceoreliminatemedicationsthatimpairhydrochloricacidfunction

• Ensuresufficientdigestiveenzymes

• Identifyeachorganofdigestion&ensureitisworkingwell• Treatgutpermeability

• Eatavarietyofprebioticfoodsincludingsoluble&insolublefibers• Eatavarietyofprobiotic“fermented”foods

• Followfoodcombinationprinciplesforbetterdigestion

Essential Steps to Nourish the Second Brain


• Differentforeveryone&basedonindividual“biochemistry”

• Essentialduringtimesofstressbecauseproteinsupportsgrowth

&repairinthebody,whichtendstobreakdownunderstress

• Increaseifoneisdoingvigorousexercise•Womengenerallyneedlessproteinthanmen

•Mustbeeasilyassimilated

• Alcohol&drugrecovery:startsimplebrothsorcollagen/gelatin

Protein Requirements


• Proteinfromanimalfoodshavebetteraminoacidprofilesthanplant

proteins

• PeoplewhoeattheStandardAmericanDiet(SAD)consumepoor

qualityproteinatnearlytwicetheamountnecessary

• Vegetariansmayunderconsumeproteins&overconsumesimple

carbs,sugar

• Inadequatedigestionofproteinsratherthaninsufficientintake,oftencausesproteindeficiency

Protein & Diets


• Proteinsalongwithvegetablesarepartofthesatietycomplex

• Beinggratifiedorfedbeyond• Fullness/Satietyisimportant,

especiallywhenmakingdietary

changes

• Compulsive,nighteating

disorder,bulimia

Protein & Satiety

26


Fat & The Second Brain


• Providesenergyandlubricationforthebrainandinsulationforbodyorgans

• Essentialfortheabsorptionofnutrients,• Fat-solublevitaminsA,D,E,&Krequirefatfortransporttocells

• Threemaincategoriesofdietaryfatsrequiredforgoodmentalhealth

• Saturated•Monounsaturated

• Polyunsaturated

Fats


• Thebrainismadeupof60%fat,calleddocosahexaenoicacid(DHA)

• Fatsfromanimals,vegetables,nuts,&seedsextractedviaa“coldprocess”

canbeintegratedintoadailyschedule

• Eggs,richincholine,indailydietforthebrain&memory

• EvidenceforsupplementationofDHA(&EPA)formentalhealth

• MenseemtodobetterwithEPA&womenwithDHA (Phang2013)

• NeedsforDHAvs.EPAchangeatdifferentlifestages• DHAearly…EPA…LatelifemoreDHAforstructuralsupport

Fats & The Brain


• Anti-bacterial,anti-fungal&anti-inflammatory

• Traditionalfats-butter,coconut,tallow,&suet(fromcows&lambs);ducks,

geese,chickens&turkey;lardfrompigs

• Naturalsaturatedfats-butyricacid(butter),lauricacid(coconutoil&palm

oil),myristicacid(dairyproducts),

palmiticacid(meat&palmoil),&

stearicacid(meat&cocoabutter)

Saturated Fat

30


• Commerciallycreatedformoffat

• Doesnotoccurinnature• Unhealthy,contaminantbyproduct

ofcommercialhydrogenationof

vegetableoils

• Hydrogenationrendersliquidvegetableoilsascreamy,

spreadablesubstancesusedto

makemargarines&baking

shortenings

Trans Fat

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• Avocadoandavocadooil,olives&oliveoil,&

treenuts

• Oliveoilbestwhenraw&notusedincooking

• Medicinal

• Gallbladder

• Highinchlorophyll;detoxifiestheintestinal

tract

• ChooseFull-fatdairyproducts(notlowornon)

• Lamb,beef,&wildlifesuchasdeer,elk,

moose,&bear

Monounsaturated Fats

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AVOID• Soybeanoil,cornoil,sunfloweroil

CHOOSE• Nuts,seeds,leafygreens,&fattyfishsuchassalmon,tuna,herring,

mackerel,&sardines

• Lowinsaturatedfat&cholesterolfree• Containtwotypesofessentialfattyacids:Omega-3&Omega-6

Polyunsaturated Fats

33


• Avoid“hydrogenated”or“partiallyhydrogenated”products➔

Impairedimmunefunction

• Liverdamage,impairedreproductivehealth,damagetothe

lungs,&digestivedisorders

• Learningdelays,weightgain,&neurologicalproblems

• Polyunsaturatedfat➔rancid&moretoxicwhenusedforfrying,

➔inflammation➔depression&pain

Polyunsaturated Fat Warnings

34


• Essentialtohealth&recovery•Mustbeobtainedthroughfoods

•Maintypes:•Omega-3(linolenicacid)

•Omega-6(linoleicacid)

• Arachidonicacid(AA)

Essential Fatty Acids (EFA)

Introducing good quality fats into the diet as both foods and supplements and eliminating poor-quality fats is the 1st step to begin a nutritional program of recovery.


• Specialtypeoffatthatcompriseneuronmembranes&

supportcommunicationbetweenneurons

• Problemsinphospholipidmetabolismcontributeto

majordepression,schizophrenia,&bipolardisorder&

autismspectrum(Eggers,2012;Horrobin,2001;Leyse-Wallace,2008)

Phospholipids

36


Carbohydrates & The Second Brain

37


• Essentialtoahealthycolon&mentalhealth

• Nocaloriesorfoodenergy;crucialcomponentofahealthydiet

• Passesthroughthedigestivetractundigested,sweepsupdebrisalongthecolonwalls,&addscontenttodigestedfood

• Causesmicrobesintheguttoreleaseawasteproductcalledacetate

thatsignalstostopeating,whichthensuppressestheappetite

Fiber – A Complex Carb


•Fermentedfoodsareamongthebest

sourcesoffiber&promoteboth

intestinal&brainhealth

•Include:

Fiber & Fermented Foods

Ancestral diets provide 10 times more fiber than the SAD diet.

•Yogurt&cheeseswithlivecultures

•KefirorKephir•Sauerkraut•Kimchi&miso

39

•Kombucha

•Micro-algaes

•Brewer’syeast•Yakult


• Soluble,indigestibledietaryfiberssupportthebeneficialgutmicrobiota(bacteria)inthecolon

• Thecolonic“garden”soprobioticsormicrobiotacanflourish&

notallowtheharmfulbacteriatopropagate

• Raw&cookedonions,garlic,Jerusalemartichokes,leeks,

asparagus,wheat,beans,bananas,agave&dandelion,&

chicoryrootoftenfoundincoffeesubstitutes

Prebiotics

40


• Psychobiotics:“aliveorganismthat,when

ingestedinadequateamounts,producesa

healthbenefitinpatientssufferingfrom

psychiatricillness”(Dinan,Stanton,&Cryan,2013,p.720)

• Probioticsupplementsmaybeboughtin

capsuleorliquidforminahealthfood

store&shouldbetakenwithfood,noton

anemptystomach

Psycho-biotics

One of our goals with nutrition is to support healthy bacteria so the dangerous type will go elsewhere.

41


• 400-500differentkindsofhealthymicrobiotainhabit

thegut

• Theypromoteahealthydigestivesystem,prevent

infections,diarrhea,inflammation,&improveimmune

health

• Theyproducenutrients,suchasvitaminK,Bvitamins,&

someshort-chainfattyacidslikelacticacid&folate

Probiotics & Microbiota


• Mixofbothsoluble&insoluble

fiber

• RichinOmega-3fattyacids

• Tip:Ancestraldietarypracticesincludedrinkingaglassofwatereachmorninginwhichchiaorflaxhasbeensoaked,thusprovidingfattyacids&fiber

Chia - A Unique Prebiotic

43


• ProbioticsproduceGABA&serotonin• Reducestress&decreaseanxiety

• ProbioticseasedigestiveproblemsbyregulatingGABA

• Lowersthestressresponseinthegut• GABAa“naturaltranquilizer”• Leadstoreductionofanxiety

(Bravoetal.,2011;Berciketal.,2011)

Probiotics & GABA


• TheColon• Peristalsisisarhythm

• Stress&peristalsis

The Elimination Process


• SymptomsofPoorElimination

• Ask:Howoften,quality,easeofelimination,hemorrhoids

• MentalHealth&EliminationProcess

• Colitis,IBS• Stressproducespeptidesthatregulatemotility

• Childrenwithchronicconstipationassociatedwithphysicalsexualabuse• Analrelaxationisararefindinginretentiveconstipation• MedicallyUnexplainedSymptomsAssociatedwithAdverseChildhoodEvents

Intersection of Physical & Emotional Elimination


Summary

• Digestiveproblemsisofteninvolvedinmentalillness

• Leakygutleadstothepassageofintestinalcontentintothebloodstreamthatdoes

notbelongthere

• Boththe1stand2

ndbrainareinvolvedindigestion

• FatsareessentialforbrainhealthandEPA/DHA

• TransFatsaredangeroustothebrain&arteries

• Requirementsmaychangebygender&stageoflife

• ProbioticsarealsocalledPsychobiotics

• TheyincreaseGABAtheanxiolyticNT

• FiberisessentialtoSatiety&colonhealth

• Probioticssetthestageforthecolonicgardentogrow

Thank you!drlesliekorn.com [email protected]