Healthy Gut, Healthy Brain

Transcription

1 Healthy Gut, Healthy Brain Kate Spitzer, RD, LD Brain Ma2ers, March 10, 2018

2 Katherine Spitzer, RD Kate is a registered die<cian with TriHealth Fitness & Health Pavilion She provides individual nutri<on consults and follow up appointments for weight management and behavior modifica<on, previous bariatric surgery, hypertension, high cholesterol/ triglycerides, gastrointes<nal disorders, blood sugar management, general healthy lifestyle, label reading and meal planning; Weight loss classes (HealthOne), InBody Body Analysis, Health Living Workshops, and cooking demonstra<ons.

3 Objectives: DISCUSS: the mind- gut axis LEARN: new discoveries in the microbiome FUEL: What foods fuel a healthy gut? A healthy brain? SUMMARIZE/APPLY: how to make shi`s toward a diet that supports a healthier gut and brain

4 The brain-gut axis

5 The brain-gut axis Science has long thought of the brain and gut as two separate systems BUT have you ever experienced.. A gut feeling? Bu2erflies? Knots in stomach, or GI distress when stressed?

6 The brain-gut axis h2ps://foodandnutri<on.org/from- the- magazine/exploring- gut- brain- axis/

7 Two Way Street CNS ENS Central Nervous System: brain and spinal cord Enteric Nervous System: second brain system of neurons that control the func<ons of the GI system The brain and the gut communicate via: Neurotransmi2ers/Hormones Vagus nerve Microbiome (animal studies) Immune system

8 GI Tract is Sensitive to Emotion 30-40% of people have func<onal bowel problems at some point in their lives (1) A higher than normal % of people with IBS/bowel problems develop depression/anxiety (1) Stress can affect contrac<ons in the gut, worsen inflamma<on, increase infec<on risk (2)

9 GI Tract & Emotion: Evidence Researchers are finding that irrita<on in GI system may send signals to CNS that trigger mood changes (1) Studies show that IBS pa<ents that tried psych therapy had > improvement in symptoms than those who received conven<onal treatment (2) Research suggests that diges<ve system ac<vity may affect memory and thinking skills (1) IBS is considered to be a disorder of gut- brain communica<on and more recently has been associated with altera<ons in gut microbiota profiles (22)

10 Microbiome **** 100 trillion organisms housed in our GI tract, skin, and gums Unique to each individual, altered by Internal/External factors: environment, diet, genes, abx Disease Residence <me Good bacteria (3,6,9,22) Regulates immune response, creates a barrier against bad bacteria Synthesizes nutrients (B12, SCFA, bio<n, vitamin K) Harvest energy/improve absorp<on Communicate with brain via neurotransmi2ers, vagus nerve Mediate stress response in the brain

11 Microbiome and Stress Studies (animal and human) support the theory that bad (pathogenic) bacteria lead to disease Interac<ons with immune system in gut lead to release of cytokines Chronic inflammatory responses lead to chronic disease (HTN, depression, atherosclerosis, UC, MS) (3) Good bacteria interact on a hormonal level to shut off the stress response (3)

12 Leaky Gut Intes<nal permeability; physical gaps between intes<nal cells Has been associated with changes in mood, immune func<on, and inflamma<on (21) May be associated with IBD, Celiac Disease, T1DM (21) Studies show that stress and a Western diet increase the permeability of the intes<ne (19) Researchers argue that a tradi<onal diet (Mediterranean/Japanese) can provide an<- inflammatory benefits and therefore result in mood support (19)

13 We Are What We Eat People who eat a processed diet have different gut composi<on than those who eat whole foods (3) In mice, a change in diet from low fat/plant based to high fat/sugar shi`ed the structure of the microbiota in 1 day(5) In a controlled feeding study of 10 ppl, changes in gut flora occurred in 24 hours of star<ng a diet (high fat/low fiber vs. low fat/high fiber) (6) Studies suggest that gut flora adapt to changes in calorie intake, and this can affect the amount of nutrient absorp<on from dietary intake (6) High fiber diets are associated with decreased energy harvest (6) Energy balance may help maintain a gut profile associated with reduced disease risk (6) Underfed: gut microbiome/diversity change, associated with anxiety/depression (21)

14 Neurotransmitters produced by gut bacteria Most evidence re: microbiome and effect on brain is in mice/rats Strains of bacteria that affect the brain or behavior psychobio<cs (3) GABA- made by bacteria in fermented foods, an<- inflammatory, pathway for vagus nerve to brain (4) Norepinephrine Dopamine Acetylcholine Serotonin: regulates sleep, appe<te, mood, and pain response (9) 95% is produced by the gut

15 Pre/Probiotics; Fiber and Fermented Foods Probio<cs: the good bacteria / live cultures Fermented foods: kefir, yogurt, kombucha, soy sauce, tempeh, miso, sauerkraut, aged cheese Fermented foods can improve bioavailability of B vitamins, magnesium, and zinc (19) Pre- bio<cs: non- diges<ble food components that promote the growth of good bacteria in the gut Fructooligosaccharides: fruit, veg, bananas, onion, garlic, leeks, ar<chokes, whole- wheat, soybeans

16 Pre/Probiotics: Evidence 1 study of overweight individuals who consumed fermented milk had 5% decrease in visceral abd fat (6) Pregnant women had decrease in rates of gesta<onal DM (6) RNY pa<ents had superior weight loss (6) Poten<al improvement in anxiety, stress, outlook, depression, and cor<sol levels (9,19, 20) Prebio<cs: IBS pa<ents had improved anxiety symptoms (19) May modulate the produc<on of cytokines (stress response) (4) Fermented soy (Japanese diet) linked to lower rates of depression (19)

17 What about the brain?

18 Brain Food Balance Carbohydrates The brain s preferred energy source Prebio<cs Proteins Building blocks for brain messengers Blood sugar balance, sa<ety, weight control Fats Essen<al fats (DHA) are required to keep the brain func<oning Blood sugar balance, sa<ety, weight control TYPE IS IMPORTANT!!!!

19 Omega 3 s Essen<al fats Dietary deficiency has been linked to increase risk of ADD, demen<a, dyslexia, bipolar, and schizophrenia Long term adequate DHA is associated with improved memory, learning ability, and decreased cogni<ve decline (7) What about supplements? RCT compared DHA to placebo, did not slow rate of cogni<ve decline in people with AD (12) Assump<ons are based on preclinical findings, evidence is not convincing for omega3 supplements in treatment of AD(11)

20 Dietary Sources of Omega 3 s Fa2y fish (recommend 8 oz per week) Salmon (preferably wild caught) Trout Herring Albacore tuna Mackerel Walnuts Chia seeds Flaxseeds Research suggests ea<ng fish improves memory (7)

21 Antioxidants Protect brain cells from damage caused by free radicals Dark green vegetables may improve memory (8) Broccoli Cabbage Dark leafy greens Brightly colored berries (anthocyanins/flavanoids) may boost memory (8) Blackberries Blueberries Cherries

22 Dementia, Alzheimer's Disease, and Diet Heart Healthy = Brain Healthy The best foods for memory/brain health are those that encourage good blood flow A healthy diet may help slow the progression of natural cogni<ve decline (12) Pro- inflammatory diet (sugar, salt, trans fats) is associated with CVD, stroke, demen<a (11) Trans/Saturated fats adversely affect cogni<on (10) Diets rich in an<oxidants decrease the risk of demen<a (11) Studies have linked excess body fat (belly) with increased risk of demen<a

23 Putting it All Together.

24 Heart Health = Brain Healthy = Gut Healthy Focus on fruits/vegetables An<oxidants + prebio<cs Plant- based fat sources Omega 3s, DHA Fermented foods Natural probio<cs Avoid/Limit trans/saturated fat Sugar Salt

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26 Mediterranean Diet Heart healthy, lower risk of cancer, Parkinson s and Alzhiemer s (15) Be2er cogni<ve func<on, memory, and altertness; lower risk of depression and demen<a (8,9) Plant- based Fruit, veg, nuts, legumes Red meat limited to 2x per month Fish/Poultry at least 2x per week More olive oil, less bu2er More herbs, less salt Lifestyle Habits: Enjoy meals with family,? Red- wine, + exercise!

27 DASH Diet Low salt Whole/unprocessed foods Lifestyle Habits: Small changes Self- compassion Physical Ac<vity Support

28 MIND Diet (17) Developed by Martha Clare Morris, PhD, a nutri<onal epidemiologist from Rush University? Lower risk of AD Combina<on of Med/DASH Fish at least 1x/week Beans every other day Nuts almost daily Berries and poultry at least 2x/week 3 servings whole grains, salad and 1 vegetable, glass of red wine daily

29 Practical Application Swap out red meat for fish at least 1x/week? Switch refined grains to a whole source? Half plate veggies? Dip (whole wheat) bread in olive oil instead of bu2er? Subs<tute fruit for a sugary dessert at least 3x/week? Incorporate a fermented food at least 2x/week? Wine and cheese?????

30 Resources/References: 1 h2ps:// brain- gut- connec<on 2 h2ps:// and- condi<ons/the- gut- brain- connec<on 3 h2ps:// psychiatry/201404/the- gut- brain- connec<on- mental- illness- and- disease 4 h2ps:// psychiatry/201206/groovy- probio<cs 5 h2ps:// 6 h2p:// 7 h2ps:// aging/brain- health- and- fish 8 h2ps:// aging/memory- boos<ng- foods 9 h2ps:// psychiatry- your- brain- on- food h2ps://

31 Resources/References: 11 h2ps:// 12 h2ps:// _Nutri<on_for_Brain_Health.pdf 13 h2p:// 14 h2ps:// vitality/blog/three- promising- diets- to- improve- cogni<ve- vitality? gclid=cjwkcaiaz- 7UBRBAEiwAVrz- 9T95cOy4GGRpi6B0zf9FF1mkAB8FaTNWTsfLh7u1JCC0BS2nFKVVqBoCaoE QAvD_BwE 15 h2ps:// lifestyle/nutri<on- and- healthy- ea<ng/in- depth/mediterranean- diet/ art ?pg=1 16 h2ps:// lifestyle/nutri<on- and- healthy- ea<ng/in- depth/dash- diet/ art ?pg=2 17 h2ps:// may- help- prevent- alzheimers 18 h2ps:// vitality/blog/manage- hypertension- prevent- demen<a 19 h2ps:// 20 h2ps://

32 Resources/References: 21 h2ps://foodandnutri<on.org/from- the- magazine/exploring- gut- brain- axis/ 22 Harvard School of Public Health: Gut Microbiome Symposium Fall 2016