Tuesday, March 4, 2014

Metabolism and Mental Health

Hi everyone!

I'm back from some time away and am thrilled to announce the birth of our second daughter Kathryn!  Kudos to my beautiful wife who delivered her naturally and has been an amazing trooper plowing through breast feeding challenges! Let's just say, there's not a lot of sleep to go around in our home right now!

On to today's topic: Metabolism and Mental Health

I'm constantly disgusted by the preachings & teachings of many of my peers who blindly tow the economically motivated company line!  I'm speaking from both the head and the heart here!

Maybe it's not news to any of you reading this that there is something wrong with the current model of "healthy lifestyles" being touted by North American health care professionals, and I might add is still being taught as the gold standard by many of the educational institutions creating the next generation of said health care professionals!  The sad part of all this is that it's all based on poor research and worse yet, the last 2 decades of evidence has clearly shown that the food pyramids & groupings that are are NOT the answer they are touted to be and could actually be responsible for the obesity epidemic we are now facing.  Denise Minger has done an awesome job illustrating the facts as to why the USDA pyramids since the 1970's are a bad idea in her book Death by Food Pyramid.

In fact, the evidence absolutely opposes regular consumption of a high carb, low fat diet for any prolonged period of time, suggesting that the increased prevalence of mental health conditions over the last 50 years is due to the shifting of public consumption to a low fat, high carbohydrate diet vs. the more traditional, low carb, high fat one (Riby LM and Riby DM, 2013)!

I work at a mental health hospital and I see significant overlap between the mental health conditions that lead to hospitalization (i.e. Anxiety, Depression, Bipolar Disorder, Schizophrenia, Schizoaffective Disorder, Bipolar Affective Disorder, etc...) and the metabolic syndrome that has also become increasingly prevalent in our modern society.  FYI, Metabolic syndrome is defined by having 3 or more of the following conditions (as defined on the Diabetes Canada website):
  • High fasting blood glucose levels (5.6 mmol/L or higher)
  • High blood pressure (130/85 mm Hg or higher)
  • High level of triglycerides, a type of fat in your blood (1.7 mmol/L or higher)
  • Low levels of HDL, the “good” blood cholesterol (lower than 1.0 mmol/L in men or 1.3 mmol/L in women)
  • Abdominal obesity or too much fat around your waist [a waist circumference of greater than 102 cm (40 inches) in men and greater than 88 cm (35 inches) in women]
The more of these conditions you have, the higher your risks of developing type 2 diabetes and heart disease.  I can tell you from my experience, that at least 1-3 of these criteria are met by almost all the clients I come across in mental health.  It's far to common to be mere chance!  In fact, there is research outlining how these metabolic disturbances are linked with mental illness  (Carria G et al. 2014).  I think the best objective review of the evidence linking lifestyle habits with subsequent mental health issues and specifically cognitive decline is in Dr. David Perlmutter's book Grain Brain.

Furthermore, metabolic syndrome has been shown to be associated with poor memory and executive functioning in the elderly (Rouch I et al, 2014). I think we can safely assume that they are at the very least related & that nutrition and our consistent lifestyle habits are intimately involved in the pathophysiologies of these conditions.

One theory as to how this link occurs is through epigenetics or the altering of gene expression within individuals through methylation and other processes that turn on and off of various genes in the body.  Mark Sisson in his book The Primal Blueprint describes becoming a fat burning machine through altering our gene expression to do this.  Evidence is definitely starting to show that consistent lifestyle activities including diet, resistance and aerobic exercise and more do exactly this, alter gene expression of certain genes that favor fat burning and turn off others that would favor fat storage.  Epigenetic changes have been shown to occur in populations with Diabetes as well.  Interestingly, these gene expressions can be either health marker related (which can be tracked) or appetite-generating or suppressing to name a few, which can help explain how processed foods can stimulate people to over-consume them so frequently.  This phenomenon has been demonstrated clinically in a study that examined midlife diet and future phenotype expressions of Healthy Aging.



Regardless of mechanisms, there is definitely evidence that suggests we shouldn't be relying, let alone recommending high grain & refined carbohydrate intake (including grains) and that we shouldn't be restricting fat as much as we are now!

Specifically, there are a number of studies linking grain consumption to mental health issues including schizophrenia, depression and bipolar disorder.

 
I will leave you with one closing thought.  Most people know that the body is made of mostly water and if we don't get enough water daily, then we're on the road to problems; so once you understand that the brain is made of mostly fat, it shouldn't surprise you that if we don't consume adequate fat from our diet we are heading down the road to troubles with our brain!  Obviously, the types of fat matter, but this is another post in and of itself!



Anyway, I believe the time is coming for change & I am striving to advocate for it!  It will likely be many years until Government agencies climb aboard, so in the meantime, take control of your and your family's health!

Also, to any and all clinicians reading this, you should try the changes I'm talking about and advocate for change too!  To blindly move forward is irresponsible!


Till next time.  Have a great weekend & Take care!

Dan T

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