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Welcome to the Open Sky Webinar We will be starting at 6 pm – see you soon!

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Presentation on theme: "Welcome to the Open Sky Webinar We will be starting at 6 pm – see you soon!"— Presentation transcript:

1 Welcome to the Open Sky Webinar We will be starting at 6 pm – see you soon!

2 The Role of Nutrition in Open Sky Treatment: Connections between Nutrition and Mood Joanna Bettmann Schaefer, PhD, LCSW Open Sky Wilderness Therapy

3 Why is Nutrition Important? Let thy food by thy medicine and thy medicine be thy food. - Hippocrates, 400 BC Basic foundational piece Simple intervention that is often overlooked Can apply to any setting or environment

4 Agenda Overview of research on nutrition and behavior The role of a balanced diet Why a balanced diet is critical for mental health Open Sky nutritional interventions Data from the field Recommendations for home nutrition

5 Research Links Nutritional Factors to Mental Health People with nutrient deficiencies often manifest psychological symptoms first, rather than physical symptoms (Benton, 1992) Nutrition is the simplest single intervention for treatment of behavioral issues Dietary improvement and supplementation may offer an inexpensive and acceptable adjunct to standard treatment [of depression]; yet this has, to date, been largely overlooked, owing to lack of evidence and knowledge. (Bamber, Stokes & Stephen, 2007)

6 Research Links Nutritional Factors to Mental Health Unhealthy eating has been associated with suicide attempts, delinquency, substance abuse and other behavioral issues in adolescents (Neumark-Sztainer, Story, Toporoff, et al., 1997) Dietary intervention alone has been shown to improve hyperactive and disruptive behavior in children (Schmidt et al., 1997) A healthy diet can have a protective effect against depression in adolescent girls (Brooks et al., 2002)

7 Research Links Nutritional Factors to Mental Health Specific nutrient levels are commonly low in some mental health clients Supplementation leads to symptom improvement (Bamber, Stokes & Stephen, 2007) Vitamin B1 intake has been linked to behavioral improvements, even in patients with adequate Vit. B1 levels (Benton et al, 1997) Participants reported feeling more clearheaded, composed, and energetic. Low folic acid levels are associated with a lack of clinical response to treatment in depression (Papakostas et al, 2004) Folic acid has been shown to enhance effectiveness of Prozac in treatment of depression (Coppen & Bailey, 2000 )

8 Components of a Balanced Diet Complex carbohydrates: Major source of fuel Brain function and physical activity Fiber: Important for aiding elimination and pushing waste out of our bodies Examples: Brown rice, quinoa, fresh fruits, and veggies

9 Components of a Balanced Diet Simple carbohydrates should be avoided: Nutritional value removed during processing Can cause unhealthy weight gain Can spike blood sugar Examples: white sugar, white flour, white rice, candy, soda

10 Components of a Balanced Diet Proteins: Basic structural components of all body parts (e.g. bones, muscle, organ tissue) Critical for neurotransmitter function, healthy cell metabolism, and energy Examples: red meat, eggs, quinoa, nuts, beans, chicken, fish

11 Components of a Balanced Diet Proteins also play an important role in serotonin production Proteins are made of amino acids Amino acids help to create neurotransmitters (i.e. dopamine and serotonin) Some suicidal individuals demonstrate altered serotonin activity (Mann, 2003) Without adequate protein, we do not have the raw materials needed to maintain mood and regulate behavior

12 Components of a Balanced Diet Vitamins and Minerals: Drive healthy body systems Are crucial co-factors for every cellular function in the body Without essential nutrients, we become susceptible to physical and mental imbalance or disease (Papakostas et al, 2004)

13 Components of a Balanced Diet Essential Fatty Acids (EFAs) We all need good fats for optimal central nervous functioning Many American are afraid of the word fat, but a significant portion of our brains is made up of fat Adequate amounts of EFAs are necessary throughout life to maintain normal central nervous system and proper sleep function (Richardson and Puri, 2000) EFAs aid in balanced hormone production Examples: fish, raw nuts, raw seeds, whole grains At Open Sky, we support this by offering students fish oil and primrose oil in the field

14 EFAs and Mental Health Deficits in EFAs have been linked to many commonly seen behavioral and psychological issues like ADHD, depression and anxiety (Colquhoun and Bunday, 1981; Peet, Murphy, Shay and Horrobin, 1998) Increased EFAs create a more fluid cell membrane which increases serotonin transport (Block and Edwards, 1987) The fats in cell membranes affect neurotransmitter functioning. For example, Valium efficacy can be doubled by altering the fatty acid environment. (Richardson and Puri, 2000)

15 The Role of Essential Fatty Acids (EFAs) Chronic omega-3 fat deficiency has been linked to decreased levels of dopamine (Richardson and Puri, 2000) This correlates to symptoms of ADHD, anxiety, and depression (Peet, Murphy, Shay and Horrobin, 1998) Impulsivity symptoms improved with EFA supplementation (Hallahan and Garland, 2004) EFAs have been shown to decrease depressive symptoms while not inducing manic symptoms in the treatment of bipolar disorder EFAs are a naturally occurring and safe psychotropic compound (Frangou, Lewis and McCrone, 2006)

16 Essential Fatty Acids and Mental Health Things that can interfere with the conversion of EFAs to more active constituents (Richardson and Puri, 2000) : Saturated or hydrogenated fats Vitamin and mineral cofactor deficiencies (especially Zinc) Excessive alcohol consumption Stress hormones

17 Why is a Balanced Diet Critical for Mental Health? Without the foundation of balanced nutrition, we dont have the essentials to support neurotransmitter function, strong cognitive function, attention, and focus Underlying nutrient deficiencies can be associated with mental health issues (Bamber et al., 2007) Providing good nutrition significantly decreases the impact of blood sugar fluctuations and allergic responses on behavior (Benton, 2002; Swanson & Kinsbourne, 1980; Egger, 1985) Nutrients have been shown to increase effectiveness of antidepressant medication, especially in treatment-resistant individuals (Bamber et al., 2007; Coppen & Bailey, 2000; Peet & Horrobin, 2002)

18 How does this relate to the students we work with? Poor nutrition can combine with other factors to be the straws on the camels back: Eating simple carbs, no breakfast, energy drinks Using drugs and alcohol Health issues like asthma, eczema, constipation Not sleeping well These are things we can change!

19 Open Sky Nutritional Interventions Students eat 3 solid meals a day plus snacks Ensures consistent blood sugar levels Students eat a whole foods diet: no refined carbohydrates, no simple sugars, no additives or preservatives Maintains blood sugar, minimizes impact of environmental toxins Can reduce feelings of distress by limiting simple carbohydrate consumption (Christensen, 2001)

20 Open Sky Nutritional Interventions Whenever possible, produce is organic, meat is local, grass-fed and free from hormones and antibiotics Minimizes impact of environmental toxins and non-naturally occurring hormones Diet is limited in common allergens like wheat, soy, and dairy Certain foods can cause mental and behavioral symptoms via reaction to certain neuropeptides formed from foods (Rippere, 1984) Allergic responses to food have been associated with hyperactive and/or disruptive behavior (Schmidt et al., 1997) Open Sky can meet most dietary needs, ie. Peanut allergies, gluten sensitivity, or tree nut allergies Fresh produce has many more anti-oxidants and nutrients than food that has to travel long distances Nutritional supplements offered (e.g. fish oil, multivitamins, B vitamin complex)

21 Sample Day of Meals Breakfast: Oatmeal with dried fruit and nuts Breakfast burritos with sausage, spinach, potatoes, onion, and pepper Granola Lunch: Whole-wheat tortillas with: Tuna and cheese Peanut butter and fruit Chicken and cheese Dinner: Split pea soup with rice, kale, and carrots Quinoa Pasta with carrots and onions Coconut vegetable curry with yams, tempeh, and spinach Black bean burritos with onion, peppers, and cheese. Snacks: Raw nuts and seeds, fresh and dried fruits Drinks: Herbal teas

22 What We Dont Eat Ultra refined sugar or sweeteners (e.g.white sugar) Processed meats (e.g. spam) Simple carbohydrates (e.g. ramen, white pasta, white rice, white sugar) Gatorade Caffeine (e.g. chocolate, black tea) Food dyes or preservatives

23 Why We Dont Eat Those Things Refined sugars: spikes blood sugar, can cause behavioral problems, can induce fatigue and irritability (Benton, 2002) Processed meats: often have compromised nutritional value (from meat byproducts and from animal diet), introduces unnecessary hormones Simple carbohydrates: cause blood sugar dysregulation, also most nutritional value is removed during refining process Hydrogenated oils and saturated fats: negatively impact the flow of nutrients into every cell in body and interfere with healthy neurotransmitter function (Peet, Murphy, Shay and Horrobin, 1998)

24 Open Sky Nutritional Intervention: Junk Food Day Student must be in the west phase (at Open Sky for roughly 3-4 weeks) Students are given the option to have snacks and drinks that would be available at home Students eat a regular Open Sky diet, with these snacks in addition to their normal food. They must eat the Junk Food in the morning. The purpose is to invite students to experience for themselves any physical/mental/emotional changes from shifts in diet Sample Options: Sun Chips, Fritos, Potato Chips Oreos, Skittles, Mini Donuts Mt. Dew, Coke, Monster Energy drink

25 Measuring the Impact of Junk Food Day Students are asked to respond to the following questions before snacks, after snacks, and at bedtime: What is your energy level right now? What is your emotional state? How are you feeling? How is your ability to concentrate or focus? Are there any areas of pain, discomfort, or tension in your body? What was it like to do exercise (such as hiking) today? What was your meditation practice like today? What was your outlook on life today? How is your body, mind, heart, and soul?

26 Junk Food Day: Before Snacks Sample responses: Emotional state is decent, I am feeling optimistic My ability to concentrate and focus is good Mild discomfort in my upper back I feel accomplished and content Some tension but nothing irregular I feel really excited My energy is normal to high

27 Junk Food Day: During Sample Responses: Im feeling good, but guilty about all the junk food I ate Hyper, excited, distracted by junk food, stomach ache I am feeling bloated and hyper I feel a little out of it. My moods have been all over the place. Ive been silly, happy, mad, sad, manipulative, and down. I am pretty full, and sort of weak. I am sort of unstable, not thinking clearly or positively. I am feeling full and fat. I cannot concentrate or focus well. Weird feeling, hyped up, things speeding up, a high like feeling thats intense, a lot of things, going on, seems like there are less filters. I feel like my body is tired. I feel like my mind cant think. I have been talking more aggressively and my ADHD has flared out of control. My impulses are hard if not impossible to control.

28 Junk Food Day: Bedtime Sample responses: My energy is sapped. I feel hungover. My energy level is very low. I feel really tired. Kind of depressed. Depressed and irritable Extremely low energy level. Extremely depressed. Bad focus Out of it, but happy, stressed My energy is returning, but Im extremely hungry The junk food made my body more energetic, but in the long run, the healthy food made me feel a lot better.

29 Junk Food Day Behavior Patterns Addictive behavior emerges: students attitudes and behaviors mimic their substance abuse patterns (e.g. overeating) There is a link between how we feel about ourselves and how we eat (Fulkerson et al, 2004) Relationship to food: self image issues Known that we go for high carbohydrate, high fat, low protein foods when were stressed (Gibson, 2006) Peer pressure issues (e.g. sneaking food to others)

30 Recommendations for Nutrition at Home Evaluate your current home menus, focusing on removing hydrogenated oils (trans-fats), refined sugars and carbohydrates (including corn syrup), food dyes, preservatives Increase food variety: introduce grains such as quinoa, amaranth, and barley instead of potatoes, white pasta and white rice Introduce dark leafy greens such as kale, collard greens, chard, etc. Buy local where available.

31 Recommendations for Nutrition at Home Introduce healthier meat and dairy sources: organic, antibiotic-free, without hormones, cage- free, grass-fed Learn more about whole-food nutrition, supplementation, vitamin deficiencies, digestion, food allergies, emotional connection to food Consult with naturopathic physician or holistic physicians to consult with you on dietary interventions and educational needs

32 Contact Information: Joanna Bettmann Schaefer, PhD, LCSW Open Sky Research Director (801) 587-7600 Dr. Jade Wimberly, ND Consulting Naturopathic Physician, Program Liaison (970) 759-9733

33 Thank you for participating! Please help us improve our webinars by completing our survey. Simply wait for us to end the session and you will be automatically re-directed to the survey page. Thank you!

34 References Bamber, D.J. Stokes, C.S., & Stephen, A.M. (2007). The role of diet in the prevention and management of adolescent depression. Nutrition Bulletin, 32 (suppl. 1), 475-495. Benton, D (1992). Vitamin-mineral supplements and intelligence. Proc Nutr Soc, 51, 295-302. Benton, D., Griffiths, R., & Haller, J. (1997). Thiamine supplementation mood and cognitive functioning. Psychopharmacology, 129(1), 66-71. Benton, D. (2002). Carbohydrate ingestion, blood glucose and mood. Neuroscience and Biobehavioral Reviews, 26, 293-308. Block ER and Edwards, D (1987). Effect of plasma membrane fluidity on serotonin transport by endothelial cells. American Journal of Physiology, 253, C672-8. Brooks, T. L., Harris, S. K., Thrall, J. S., & Woods, E. R. (2002). Association of adolescent risk behaviours with mental health symptoms in high school students. Journal of Adolescent Health, 31, 240-6. Coppen, A., & Bailey, J. (2000). Enhancement of the antidepressant action of fluoxetine by folic acid: A randomised, placebo controlled trial. Journal of Affective Disorders, 60(2), 121-130. Colquhoun, I. & Bunday, S. (1981). A lack of EFA as a possible cause of hyperactivity in children. Medical Hypotheses, 7, 673-80. Coppen, A., & Bailey, J. (2000). Enhancement of the antidepressant action of fluoxetine by folic acid: A randomised, placebo controlled trial. Journal of Affective Disorders, 60, 121-130.

35 References, Continued Egger, J., Carter, C.M., Graham, P.J., Gumley, D., & Soothill, J.F. (1985). Controlled trial of oligoantigenic treatment in the hyperkinetic syndrome. Lancet 1(8428), 1540-5. Frangou, S., Lewis, M., & McCrone, P. (2006). Efficacy of ethyl-eicosapentaenoic acid in bipolar depression: randomised double-blind placebo-controlled study. British Journal of Psychiatry, 188, 46-50. Fulkerson, J. A., Sherwood, N. E., Perry, C. L., Neumark-Sztainer, D., & Story, M. (2004). Depressive symptoms and adolescent eating and health behaviors: A multifaceted view in a population-based sample. Preventive Medicine: An International Journal Devoted to Practice and Theory, 38(6), 865-875. Gibson, E. L. (2006). Emotional influences on food choice: Sensory, physiological and psychological pathways. Physiology & Behavior, 89(1), 53-61. Hallahan, B., & Garland, M. (2004). Essential fatty acids and their role in the treatment of impulsivity disorders. Prostaglandins, Leukotrienes and Essential Fatty Acids, 71, 211-216. Manari, A.P., Preedy, V.R., & Peters, T.J. (2003). Nutritional Intakes of hazardous drinkers and dependent alcoholics in the UK. Addiction Biology, 8, 201-210. Mann, J. J. (2003). Neurobiology of suicidal behaviour. Nature Reviews Neuroscience, 4(10), 819-828. Nazrul Islam, S.K, Jahangir Hossain, K, & Ahsan, M. (2001). Serum vitamin E, C and A status of the drug addicts undergoing detoxification: influence of drug habit, sexual practice and lifestyle factors. European Journal of Clinical Nutrition, 55, 1022-1027.

36 References, Continued Nemets, H., Nemets, B., Apter, A., Bracha, Z., & Belmaker, R. H. (2006). Omega-3 treatment of childhood depression: A controlled, double-blind pilot study. American Journal of Psychiatry, 163(6), 1098-1100. Neumark-Sztainer, D., Story, M., Toporoff, E., & Himes, J. H. (1997). Covariations of eating behaviors with other health-related behaviors among adolescents. Journal of Adolescent Health, 20(6), 450-458. Papakostas, G. I., Petersen, T., Mischoulon, D., Ryan, J. L., Nierenberg, A. A., Bottiglieri, T., et al. (2004). Serum folate, vitamin B-sub-1-sub-2, and homocysteine in major depressive disorder, part 1: Predictors of clinical response in fluoxetine-resistant depression. Journal of Clinical Psychiatry, 65(8), 1090-1095. Passeri, M., Cucinotta, D., Abate, G., Senin, U., Ventura, A., Stramba Badiale, M., et al. (1993). Oral 5'- methyltetrahydrofolic acid in senile organic mental disorders with depression: results of a double-blind multicenter study. Aging (Milano), 5(1), 63-71. Peet, M., & Horrobin, D. F. (2002). A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs. Archives of General Psychiatry, 59(10), 913-920. Peet, M., Murphy, B., Shay, J., & Horrobin, D. (1998). Depletion of omega-3 fatty acid levels in red blood cell membranes of depressive patients. Biological Psychiatry, 43, 315-19. Richardon, A.J. & Puri, B.K. (2000). The potential role of fatty acids in attention-deficit/hyperactivity disorder. Prostaglandins, Leukotrienes and Essential Fatty Acids, 63 (1/2), 79-87. Rippere, V. (1984). Some varieties of food intolerance in psychiatric patients: an overview. Nutrition and Health, 3(3), 125-36.

37 Reuben, C. (2007). The CARA Model of brain repair at the Sacramento drug court. The Townsend Letter, January, 64-70. Schmidt, M.H., Möcks, P., Lay, B., Eisert, H.G., Fojkar, R., Fritz-Sigmund, D., Marcus, A., & Musaeus, B. (1997). Does oligo-antigenic diet influence hyperactive/conduct-disordered children – a controlled trial. European Child and Adolescent Psychiatry, 6, 88-95. Swanson, J. M., & Kinsbourne, M. (1980). Food dyes impair performance of hyperactive children on a laboratory learning test. Science, 207(4438), 1485-1487. Zador, D, Lyons Wall, P.M., & Webster, I. (1996). High sugar intake in a group of women on methadone maintenance in South Western Sydney, Australia. Addiction, 91(7), 1053-1061. References, Continued

38 Suggested Readings Christensen, L. (2001). The effects of food on mood. Clinical Nutrition, 20 (Supplement 1), 161-166. Edelman, E. (2001). Natural Healing for Schizophrenia and Other Common Mental Disorders. Eugene, OR: Borage Books. Fallon, S. (2001). Nourishing Traditions: The Cookbook that Challenges Politically Correct Nutrition and the Diet Dictocrats. Washington, DC: New Trends Publishing. Gibson, E. (2006). Emotional influences on food choice: Sensory, physiological and psychological pathways. Physiology & Behavior, 89, 53-61. Joiner-Bey, H. (2004). The Healing Power of Flax: The Definitive Guide. Topanga, CA:Freedom Press: Topanga, CA. Langseth, L., & Dowd, J. (1978). Glucose tolerance and hyperkinesis. Food and Cosmetics Toxicology, 16(2), 129- 133. Larson, J. (1999). Depression-Free, Naturally. New York: Ballantine Books. Marz, R.B. (1999). Medical Nutrition from Marz, Second Edition. Portland, OR: Quiet Lion Press. McGovern, J. J., Gardner, R. W., Painter, K., & Rapp, D. J. (1983). Natural foodborne aromatics induce behavioral disturbances in children with hyperkinesis. International Journal of Biosocial Research, 4(1), 40-42. Murray, M. (1993). The Healing Power of Foods. Rockland, CA: Prima Publishing. Pfeiffer, C. (1987). Nutrition and Mental Illness: An Orthomolecular Approach to Balancing Body Chemistry. Rochester, VT: Healing Arts Press.

39 Pitchford, P. (1993). Healing with Whole Foods. Berkeley, CA: North Atlantic Books. Rapp, D. (1991). Is This Your Child?: Discovering and Treating Unrecognized Allergies in Children and Adults. New York: William Morrow and Company. Rosenthal, J. (2008). Integrative Nutrition. New York: Integrative Nutrition Publishing. Ross, J. (2002). The Mood Cure: The 4-Step Program to Take Charge of Your Emotions. New York: Viking Penguin. Sahley, B. & Birkner, K. (1998) Breaking Your Prescribed Addiction. Pain & Stress Publications. Stoll, A. (2001). The Omega-3 Connection. New York: Simon & Schuster. Swain, A., Soutter, V., Loblay, R., & Truswell, A. S. (1985). Salicylates, oligoantigenic diets, and behaviour. Lancet, 2(8445), 41-42. Tomori, M., & Rus-Makovec, M. (2000). Eating behavior, depression and self-esteem in high school students. Journal of Adolescent Health, 26, 361-67. Turner, K. (2002). The Self-Healing Cookbook. Vashon Island, WA: Earthtones Press. Weintraub, S. (1995). Minding Your Body. Portland, OR: Complementary Medicine Publishing Company. Suggested Readings

40 Web Resources

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