Clinical Nutrition- Final Exam- Nutritional Therapy for Psychiatric Disorders

What macronutrients are important for brain function

Omega 3 (EPA and DHA)

Amino acids

What vitamins are important for brain function

Thiamin (B1)

Riboflavin (B2)

Niacin (B3)

Folate (B12)

D

What minerals are important for brain function

Iron

Zinc

Selenium

What other nutrients are important for brain function

Photochemicals= fermentable and get small enough to cross blood brain barrier

Berries, spices, teas

What are the etiologies associated with Alzheimer's

Age

Family history

Female gender

Drown syndrome

HTN, diabetes, obesity, smoking, alcohol, traumatic brain injury, low education

What are the etiologies associated with vascular dementia

Atherosclerosis

Embolism

Hypertension

Increased clotting

What occurs faster and at a younger age? Alzheimer's or vascular dementia

Vascular dementia

4 A`s of Alzheimer`s that may impact nutrient intake

Amnesia

Aphasia

Apraxia

Agnosia

How could amnesia impact nutrient intake

May forget to eat or not trust the caretaker involved in meal preparation

How could aphasia impact nutrient intake

May not articulate wants, needs or requires about food

How could apraxia impact nutrient intake

Physically unable to eat, chew or swallow

-inability to use or coordinate purposeful muscle movements

How could agnosia impact nutrient intake

May not be able to use eating utensils or may forget how to feed themselves (they may not recognize what a fork is for example)

-inability ore recognize people or use common objects

What type of diets may be useful in prevention of Alzheimer`s disease

Mediterranean diet

DASH

MIND

-fruits and veggies

-extra virgin olive oil, nuts, berries

What nutrients are important for prevention of dementia

Omega 3

Dietary folate

B12

Dietary Vit E

Iron

How is omega 3 associated with dementia

Defined is assorted with endoplasmic reticulum stress and development of insulin resistance

How is dietary folate associated with dementia

Hitting the RDA of 400 mcg was associated with 55% decreased risk

How is B12 associated with dementia

Supplementation slowed brain atrophy

How is dietary Vit E associated with dementia

Protects neuronal degradation

SUPPLEMENTS NOT RECOMMENDED

How is iron associated with dementia

Accountability in brain with breakdown of myelin sheath, excess increases oxidative damage and cell death

Dietary inflammation and depression relationship

Dietary inflammation increases likelihood of depression by 31%

Good macronutrients for depression

Omega 3s (60% EPA and 40% DHA)

Protein

Low carb diets have no impact on depression

Micronutrients for depression

ZINC MOST FAVORABLE RESEARCH OUTCOMES

Folate and B12

Effect size that is no effect

0-0.19

Effect size that is small effect size

0.2-0.49

Effect size that is moderate effect size

0.5-0.79

Effect size that is large effect size

0.80+

What phytochemcials could be could for depression, how do they work?

Cocoa, coffee, green tea, honey, blueberries and curcumin

-all increase bifidobacterium and lactobacillus

Herbal supplants for depression

Saffron

Borage

St. John's wort

Kaveri

Rose root

Lavender

Macronutrients for anxiety

Carbohydrates

Omega 3s (Greater than 2 g/day)

Micronutrients for anxiety

Magnesium (at least 100 mg/day)

Vit D

B vitamins

Herbs for anxiety

Ashwagadha

Kayak

Passionflower

Lavender oil aromatherapy

What impact does exercise have on anxiety and depression

Exercise had a moderate effect size on decrease anxiety

For depression its more beneficial than no treatment but not as beneficial as therapy or medications, moderate feet on depression when added to meds

How does stress impact anxiety

Prenatal and postnatal increase via microglia

Psychological stress induces intestinal and BBB permeability, increased cortisol

Maternal obesity or high fat consumption increased anxiety in offspring, permanent neurodevelopment changes

What nutritional therapy might be warranted for patients with CFS/FMS?

Mediterranean diet

Low FODMAP if GI issues are present

What is CFS and FMS

Chronic fatigue syndrome

Fibromyalgia Syndrome

CFS is a part of the spectrum of diseases of

Fibromyalgia and IBS, and may be linked to autoimmune disorders

Would probiotics be useful in psychiatric conditions? Why?

Possibly because of their benefit to the gut health and therefore the brain

What is chronic pain

Pain which has persisted beyond normal tissue healing time (usually 3 months)

What nutritional strategies are associated with decreased chronic MSK pain?

Mediterranean diet

Vegetarian/vegan

Energy restriction

Low FODMAP

Omega 3 supplement

Supplements of L carnitine, Vit D, C, E or CoQ10

Probiotics

What is the supplementation recommendation for omega 3 for chronic pain

3 g/dau

How does dietary acid load relate to MSK pain

Acid load significantly was associated with higher pain scores using both measures of dietary acid load

What is found on the Chronic Pain Pyramid

Sociocultural

Biological or physical or psychological

Then pain, effects and suffering

Physical causes pain

Psychological causes suffering

What is an important pain regulator for both the central sensitization and a peripheral sensitization

Calcium

Difference between central sensitization and peripheral sensitization

Both are the same except central is over excitement of the microglia and perishable is over excitement of the non neuronal cells (mast cells, macrophages, etc)