Food is Medicine Approach to Depression

FOOD OR DRUGS? THE VERDICT

The evidence suggests that the nutritional approach it not only more effective than anti-depressant drugs it has nothing like the risk of often quite serious side-effects. So, why not do it? Well, you could argue that there’s not enough research to conclusively prove all these benefits. The trials are quite small, although well designed. That’s true to an extent and it’s also unlikely to change since there’s little profit to be made from non-patentable nutrients such as omega 3, folic acid or 5-HTP. Psychiatrist Dr Erick Turne from the Mood Disorders Center in Portland, Oregon, who uses 5-HTP in his practice, says: ‘Unfortunately, because 5-HTP is a dietary supplement and not a prescription pharmaceutical, there is comparatively little financial incentive for extensive clinical research.’

What’s more most GPs are also unfamiliar with this kind of food-based medicine. “A GP receives virtually no training in nutritional approaches to depression. It’s an obvious oversight given the wealth of evidence,” says André Tylee, professor of primary care mental health at the Institute of Psychiatry. But that is no reason why you shouldn’t try it yourself with the help of a trained clinical nutritionist. Click here to find one near you.

WHAT WORKS

The Building blocks: Most of these studies used 300mg of 5-HTP, however we ideally recommend starting with 100mg, or 50mg twice a day. 5-HTP is best absorbed either on an empty stomach or, ideally, with a carbohydrate snack such as a piece of fruit or an oatcake. Otherwise, make sure you eat enough protein from beans, lentils, nuts, seeds, fish, eggs and meat, which are all high in tryptophan. If your motivation is low you could also supplement 1,000mg of tyrosine.

The Catalysts: test your homocysteine level, which can be done using a home test kit (If your level is above 9mmol/l take a combined ‘homocysteine’ supplement of  B2, B6, B12, folic acid, zinc, and TMG, providing at least 400mcg of folic acid, 250mcg of B12 and 20mg of B6. If your homocysteine score is above 15mmol/l double this amount. Also eat B vitamin rich whole foods – whole grains, beans, nuts, seeds, fruits and vegetables. Folic acid is particularly rich in green vegetables, beans, lentils, nuts and seeds while B12 is only found in animal foods – meat, fish, eggs and dairy produce.

Fish oils: You need about 1,000mg of EPA a day for a mood boosting effect. That means supplementing a concentrated Omega 3 Fish Oil capsule providing 500mg, twice a day and eating a serving of any of the above fish three times a week.

A stable fuel supply: Eating a diet that will stabilise your blood sugar (known as the Low GL diet)  and supplementing 600mcg of chromium. Supplements generally come in 200mcg pills. Take two with breakfast and one with lunch. After a month reduce to one with breakfast and one with lunch. Don’t take chromium in the evening as it can be stimulating.

Dig deeper by reading Food is Better Medicine Than Drugs for all the evidence to support this approach, and its comparative effectiveness and safety compared to the conventional treatment of depression.

WORKING WITH YOUR DOCTOR

Much of what we recommend you can either do for yourself or seek the guidance and support of a nutritional therapist. However, the process of weaning yourself off anti-depressants is something you need to do with the support and guidance of your doctor. We recommend that 5-HTP not be taken in significant amounts, above 50mg, if you are on an anti-depressant – 5-HTP helps the body make serotonin while SSRI anti-depressants stop it being broken down. If your doctor is willing to wean you off anti-depressants it helps, at the same time to wean you on to 5-HTP, gradually building the daily amount up to a maximum of 300mg, but no more than 100mg before your are completely off the anti-depressant. In our experience this minimises and shortens the withdrawal effects that many people experience coming off anti-depressants.

The Brain Bio Centre in London treats people with depression using a Food is Medicine approach.

Food is Medicine Approach for Memory Loss and Alzheimers

FOOD OR DRUGS? THE VERDICT

Every year in Europe, a million people are diagnosed with memory decline, and 400,000 of them go on to be diagnosed with dementia. If you are over 35, it’s time to think about Alzheimer’s. As strange as this may sound, we now know that it takes approximately 40 years to develop Alzheimer’s and there are no obvious signs, except perhaps a minor deterioration in memory and concentration, for at least the first 20 years of the disease process. Many people think of this as ‘getting old’, but you can age without excessive memory loss.

Most of the current medications – donepezil (Aricept), rivastigmine (Exelon) and galantamine (Reminyl) – can temporarily improve or stabilize the symptoms of dementia, but once you stop your prescription, you’ll deteriorate rapidly and within six weeks you will be no better than someone who has never taken the drug.

What all this adds up to is that Alzheimer’s, which accounts for the vast majority of cases of dementia, is preventable. What is equally clear is that there is no drug that can do anything except, at most, briefly delay the debilitating symptoms. The nutritional approach, however, could play a role beyond the preventative, as valuable as that is. It may also reverse early signs of memory and mental impairment without any associated side effects. If this proves to be so in ongoing trials, the nutritional approach should certainly be the first port of call for anyone with memory problems.

WHAT WORKS
Test your homocysteine level. If you have a relative whose mental gears are starting to slip, make sure they have a simple memory test, just to get a measure of the situation, plus a homocysteine test, which is the best indicator of risk. If their (and in fact, your) homocysteine level is above 9 units and there are any signs or symptoms of memory problems, we recommend supplementing with a homocysteine-lowering formula. This should provide vitamin B6 (20 to 100mg), B12 (100 to 500mcg), and folic acid (1,000 to 2,000mcg) a day or, better still, take an all-round homocysteine-lowering formula containing TMG and B2 as well. N-acetyl-cysteine (500mg a day). Alternatively, choose a homocysteine formula incorporating a special form of B12, methyl B12, which works best.

Up your omega-3s. To help reduce brain inflammation, we recommend supplementing with omega-3 fish oils, as well as eating oily fish two to three times a week. The ideal amount for maximizing memory and mental health is likely to be in the region of 300mg of EPA and 200mg of DHA daily, doubling this if you have age-related memory decline.

Increase your antioxidants. To ensure you are getting the proper types and amounts of antioxidants, eat lots of fruit and vegetables with a variety of colours. Think blueberries, raspberries, apples, broccoli, red cabbage, sweet potatoes, carrots and so on – antioxidants such as the anthocyanidans found in red and purple fruit and vegetables are powerful and highly efficient at scavenging free radicals. On top of this, supplement 2,000 mg of vitamin C a day, taken in two divided doses, plus 400iu (300mg) of vitamin E, as part of an all-round antioxidant that contains N-acetyl-cysteine and/or reduced glutathione.

Stay mentally and physically active. Keep learning new things and using your mind, and exercise at least three times a week. Even walking 15 minutes a day makes a difference.

Dig deeper by reading Food is Better Medicine Than Drugs for all the evidence to support this approach, and its comparitive effectiveness and safety compared to the conventional treatment of memory loss and Alzheimer’s. Also read The Alzheimer’s Prevention Plan by Patrick Holford with Shane Heaton and Deborah Colson.

WORKING WITH YOUR DOCTOR
Ask your doctor to measure your homocysteine level (or you can measure your own homocysteine level with a home test [link to homocysteine test resources]. If your level is high, you should take a supplement with B vitamins as well as zinc, TMG and NAC, and top up daily with plenty of B-rich fruit and green, leafy vegetables.

What if your doctor draws a blank or needs convincing? Show them the evidence: either lend them a copy of The Alzheimer’s Prevention Plan by Patrick Holford, or refer them to the work of Oxford’s Optima Project or the Alzheimer’s Research Trust.

If you, or a relative of yours, is prescribed Aricept, monitor changes in their memory. If it makes no difference, there’s little point in taking this drug.

What is ADHD?

Attention deficit hyperactivity disorder sometimes known as ADHD is the descriptive label given to an ever-increasing number of children with a variety of behavioural and learning problems including hyperactivity, poor attention span, lack of concentration, disruptiveness, speech problems, clumsiness, recklessness, destructiveness, defiance and irritability.

Children with ADHD have a hard time at school and at home. They perform badly, get into trouble, have difficulty making friends and are often shunted from school to school. Untreated, such children often grow up to become delinquent teenagers going off the rails with alcohol and drugs.

What causes ADHD?

The reasons behind the ADHD disaster are not clear, but potential causative factors include smoking, heredity, drinking or drug abuse during pregnancy, oxygen deprivation at birth, prenatal trauma and environmental pollution.

Medical treatment for ADHD usually involves use of the drug Ritalin, which is a habit-forming amphetamine with many properties similar to cocaine. However research has found that Ritalin is ineffective in controlling the effects of ADHD – in fact in some cases it can make symptoms worse. What's more, Ritalin has a number of side-effects including increased blood pressure, heart rate, respiration and temperature, stomach pains, weight loss, growth retardation, facial tics, muscle twitching, euphoria, nervousness, irritability, agitation, insomnia, psychotic episodes, violent behaviour, paranoid delusions, hallucinations, bizarre behaviours, heart arrhythmias and palpitations, psychological dependence and even death.

The good news is that more often than not, children with ADHD have one or more nutritional imbalance that once identified and corrected can dramatically improve their energy, focus, concentration and behaviour.

How to improve ADHD Symptoms

* Correct Vitamin and Mineral Deficiencies

The effect of vitamin and mineral supplements on academic performance and children's behavioural problems is well documented and although it currently seems unlikely that ADHD is caused solely by nutrient deficiencies, addressing such deficiencies can significantly improve ADHD symptoms. Deficiency of Magnesium for example leads to excessive fidgeting, anxious restlessness, coordination problems and learning difficulties. The other key nutrients to watch out for are Zinc, Vitamin C, Vitamin B3, Vitamin B6, iron and copper, calcium, chromium and selenium. However, since we are all biochemically unique it is advisable to contact a trained nutritionist for advice on a specific supplement programme for you

* Increase  Essential Fatty Acid Intake

Many children with ADHD are deficient in essential fatty acids and have associated symptoms such as excessive thirst, dry skin, eczema and asthma. In addition to inadequate dietary intake, a deficiency in essential fatty acids can occur if EFAS are either not absorbed properly or not converted into prostaglandins that help the brain communicate. EFA intake can be increased by giving children more oily fish (salmon, sardines, fresh tuna, mackerel) and seeds such as flax, hemp, sunflower and pumkin or their cold pressed oils. It may also be necessary to find replacements for wheat, dairy and foods rich in salicylates (prunes, raisins, raspberries, almonds, apricots, canned cherries, blackcurrants, oranges, strawberries, grapes, tomato sauce, plums, cucumbers and Granny Smith apples) since these can block the conversion of fatty acids to prostaglandins. In addition it is important to address any deficiencies in vitamins and minerals- vitamins B3, B6 and C, plus the minerals Biotin, Zinc and Magnesium are all needed for the enzymes that power the conversion

* Eliminate Chemical Food Additives & Check Other Potential Allergens Such as Wheat, Dairy, Chocolate, Oranges & Eggs

According to research, children with ADHD are seven times more likely to have food allergies than other children. Foods most likely to cause allergic reactions include food colourings, flavourings, synthetic additives, wheat, dairy products, corn, yeast, soya, citrus, chocolate, peanuts, eggs and foods containing salicylates. When allergy is contributing to ADHD symptoms, there are often associated issues such as nasal problems, excessive mucus, ear infections, tonsillitis, digestive problems, bad breath, eczema, asthma, headaches and bed wetting. To test if food allergy is contributing to your child's symptoms, eliminate any suspect foods for two weeks and then observe carefully as you introduce foods one by one. Alternatively you may wish to consider a proper allergy test using the IgG ELISA method (cost ranges between £150-£300 depending on the number of foods tested and the chosen laboratory).

* Eliminate Sugar

The role of sugar in ADHD is controversial and while some studies show that hyperactive children eat more sugar than other children, other research suggests that sugar itself does not cause hyperactivity and can even have a calming effect. Interestingly, however, a study of 265 hyperactive children found that more than three quarters had abnormal glucose tolerance. It may well be then that the problems experienced by ADHD sufferers are caused by a combination of the form that sugar comes in, the absence of a well-balanced diet and abnormal glucose tolerance.

To improve glucose tolerance, remove all forms of refined sugar and foods containing refined sugar and replace them with wholefoods and complex carbohydrates (brown rice and other wholegrains,oats,lentils, beans, quinoa and vegetables). It also helps to balance carbohydrates with protein, (half as much protein as carbohydrates at every meal and snack), by for example eating nuts with fruit or fish with rice etc.

* Have a Hair Mineral Analysis Test to Determine Whether Heavy Metal Intoxification is Contributing to ADHD Symptoms

The flip side of the detrimental effects of low levels of essential nutrients on ADHD sufferers is that excess levels of anti-nutrients can also induce symptoms. One such anti-nutrient is lead which can cause aggression, poor impulse control and short attention span. Also important are high levels of copper, and aluminium and studies have found links between these toxic metals and hyperactivity symptoms. Many toxic elements deplete the body of essential nutrients such as Zinc and can therefore contribute to nutritional deficiencies. A hair mineral analysis test can be helpful in determining whether heavy metal intoxication is contributing to ADHD symptoms.

* Supplement DMAE

Some children with ADHD disturbances suffer from 'reward deficiency syndrome' characterised by a constant need for stimulation. This is thought to occur because they either don't produce enough of the motivating neurotransmitter dopamine (from which adrenalin and noradrenalin are made) or don't respond strongly enough to their own dopamine. For these children the stimulating brain nutrient DMAE is highly effective

Further Reading

Holford, P., Optimum Nutrition for the Mind, Piatkus 2003

ADHD – Hyperactive Children: A parents' Guide, Hyperactive Children's Support Group, 2002. To order, see www.hacsg.org.uk

Papolos, D. and M., The Bipolar Child, Broadway Books, 2000

Weintrub, S., Natural Treatments for ADD and Hyperactivity, Woodland Publishing 1997

Block, M., No More ADHD, Block Books, 2001

Holford, P. The Kid Life Crisis (feature article)

Finding Help

The Brain Bio Centre

The Brain Bio Centre is a London-based treatment centre, set up by the Mental Health Project, putting the optimum nutrition approach into practice for those with mental health problems, including depression, learning difficulties, dyslexia, ADHD, autism, schizophrenia, dementia and Alzheimer's. Click here to find out more

Find a Nutritionist

Useful Organisations

The Hyperactive Children's Support Group is a UK- based charity organisation that offers support and information to parents and professionals who wish to pursue a drug-free approach to treating ADHD. They help and support hyperactive children and their parents, conduct research, promote investigation into the incidence of hyperactivity in the UK, investigate its causes and treatments, and spread information concerning the condition. There are some local groups in the UK which have been started by the parents of hyperactive children. There are also contact parents who have offered to help newly joined members in their locality.

Contact Hyperactive Children's Support Group (HACSG) at 71 Whyke Lane, Chichester, West Sussex PO19 2PD for all information, diet booklets, articles and general requests (enclose a stamped SAE). Or call 01243 551313, or visit www.hacsg.org.uk