About 'nutrition and nutrients'|The Whole Food Philosophy: The Nutrients, And The Mojo
"An apple a day keep's the doctor away" this old adage represents the understanding of the relationship between the intake of healthy food and physical well being that people have had for generations (Bottomley & Mckeown, 2008; Jacka & Berk, 2007). It does, however, take more than one apple each day to maintain physical health it takes a wide variety of nutrients that are found in a well balanced varied diet and a moderate amount of exercise (MacDonell, 2009). The relationship between diet and exercise and mental health has not been as widely identified or accepted within the fields of medicine or psychology (Bottomley & Mckeown 2008) historically. However recent research reported a link between chronic health issues such as obesity (Bottomley & McKeown, 2008; Isenring, 2008; Porter & Evans, 2008), chronic fatigue syndrome (Hobday, et al, 2008) heart disease and diabetes (Isenring, 2008) and a higher rate of mental issues such as depression (Bottomley & McKeown, 2008; Jacka & Berk, 2007) and anxiety (Bottomley & McKeown, 2008) than the general population. Further evidence has emerged that identified a link between autism and attention deficit hyperactivity disorder (ADHD) and dietary factors (Curtis & Patel, 2008; Freeman, et al, 2006). As the role of diet and nutrition is increasingly identified as an important factor in the acquisition of mental well being and as mental health clients present with more physical illness than the general population some in the field have identified "an urgent need for effective nutrition and exercise interventions for the users of mental health services" (Isenring, 2008, p. 4). As the expertise needed to affect a complete understanding of the physical and mental processes involved in the body's assimilation of food is a "specialty in itself" (Quinn, 2009, p. 27) it is not practical for mental health professionals to attempt to acquire such. A more practical solution is for mental health professionals to gain an understanding of the dietary and lifestyle factors of the western cultures which contribute to the failing physical and mental well being of their clients as well as those dietary and lifestyle changes that will support physical and mental well being in order to integrate that understanding into an assessment and intervention process. To achieve a working knowledge of the impact of nutrition, diet and exercise on mental health and how to help clients implement changes that will support a healthy lifestyle mental health professionals must take into consideration the biological, cognitive and social influences involved in the acquisition of poor diet and lack of exercise as well as the processes involved in the acquisition of a healthy life style. According to Bottomley & McKeown (2008) there is some evidence to link the increase in mental health problems to the transition in the diet of western cultures from one of whole foods to foods that are more refined and processed. The high fat, refined sugar, nutrient poor foods of the typical American diet has a negative effect on the chemical processes in the brain which include but are not limited to the synthesis of the brain derived neurotrophic factor (BDNF) which is a "critically important protein in psychiatric illness" (Jacka & Berk, 2007, p.322) as well as "the synthesis, storage, release and actions of neurotransmitters in the central nervous system" (Jacka & Berk, 2007, p.322) like dopamine which is responsible for emotions and feeling pain and pleasure and serotonin which affects mood (Curtis & Patel, 2008) and feelings of happiness (Curtis & Patel, 2008;Schoo, 2008). A reduction of BDNF in the brain has been linked to a high saturated fat diet, a deficiency in polyunsaturated fatty acids (PUFAs) (Omega-3, Omega-6 & Omega-9) and cognitive impairment (Jacka & Berk, 2007). Further a deficiency of Omega-3 has been indicated in depression (Schoo, 2008), autism (Harvard Health Publications, 2009), ADHD (Harvard Health Publications, 2009) as well as a lower ability to deal with stress (Jacka & Berk, 2007). Other nutrients involved in the mental health processes are folate (mood), complex carbs (the production of serotonin) and tryptophan (the production of serotonin) (Bottomley & McKeown, 2008). An assessment of mental health clients' diets and exercise habits during an intake interview will help mental health professionals to identify clients whose lifestyles may contribute to their mental health issues. During an initial intake interview mental health professionals will also assess the cognitive symptoms which may be associated with or influenced by diet and lifestyle choices. Clients who report symptoms of depression may have also have poor attitudes toward health and little interest in preparing well balanced meals on a daily basis (Iizaka, Tadaka & Hiromi, 2008). Further obese clients with anxiety or depression may also have feelings of shame due to their weight (Bottomley & McKeown, 2008). Clients with feelings of low self efficacy may also have poor eating habits, little variety in their diet and a poor understanding of their own health issues (Iizaka, Tadaka & Hiromi, 2008). In children with ADHD food allergies, sugar and food additives have been reported to worsen symptoms of inattention and hyperactivity (Harvard Health Publications, 2009). Mental fatigue has been reported in clients with chronic fatigue syndrome which was reported to be alleviated by a healthy diet (Hobday, et al, 2008). Other cognitive symptoms related to poor nutrition and poor health are concentration problems, poor memory and irritability (Schoo, 2008). The mental health professional must also take into consideration the social and environmental factors that affect a client's diet, exercise and lifestyle choices. Poor diet is often related to socioeconomic status, many individuals can not afford to eat a healthy varied diet and economic considerations keep them from focusing on their health in general. Another factor that influences diet and lifestyle choices are the eating habits and the attitude about health and fitness of the family of origin which are often carried on to adulthood (Schoo, 2008). Further the messages an individual receives from media and other sources of information about the importance of health and fitness can influence a person's attitude about health and wellness. An understanding of how an individual attained attitudes about health and wellness along with the biological and cognitive assessments will help a mental health professional design a comprehensive intervention plan with the goal of gaining mental health and well being for the client. According to the literature a comprehensive intervention plan will include healthy diets, and nutritional supplements, exercise, and lowered stress. In order to avoid a client feeling overwhelmed by what may be a large amount of changes in their daily lives a progressive implementation of the intervention plan is suggested (Bottomley & McKeown, 2008). Initially a mental health professionals interested in a multi faceted approach to their clients mental well being will first implement one to three brisk ten minute walks per day (Bottomley & McKeown, 2008; Sutherland, Sutherland & Hoehns, 2003) walking is easy, safe, costs nothing and most people can fit 3 short brisk walks into their days whereas one 30 minute walk may be more difficult to plan (Sykes, 2009). The benefits of walking have been shown to be many. Those who take brisk walks regularly enjoy more energy, strengthened immune systems, lowered stress and enhanced mental well being (Sykes, 2009). Further those who walked briskly three times a day for 10 minutes were found to have lost more weight and inches than individuals who waked briskly for 30 minutes (Sykes, 2009) Along with the walking phase the mental health professional will suggest nutritional supplements which involve the addition of omega 3 (Curtis & Patel, 2008;Freeman, et al, 2006; Jacka & Berk, 2007), omega 6 and omega 9 (Curtis & Patel, 2008), zinc (Curtis & Patel, 2008; Harvard Health Publications, 2009), iron, magnesium (Curtis & Patel, 2008; Harvard Health Publications, 2009), vitamin B complex (Curtis & Patel, 2008; Harvard Health Publications, 2009), Selenium (Harvard Health Publications, 2009) vitamin D (Harvard Health Publications, 2009; Schoo, 2008) vitamin E (Harvard Health Publications, 2009; Jacka & Berk, 2007) and folate (Quinn, 2009). Although a healthy diet will also be implemented, it is essential to give the client the best opportunity to begin to gain the benefits of nutrition immediately and on a consistent basis. During the walking/supplementation phase the client will keep an eating journal. Once the healthy diet phase begins the mental health professional will use the eating journal to identify those factors within the diet that need to be changed. It is important that the changes be made gradually and at a pace that does not induce feelings of deprivation on the client's part. The goal for this phase is to move toward a time when the client includes more vegetables, fruits, and lean meats than unhealthy foods. In order to educate the client without taking up important time during sessions the mental health professional should have a good amount of written information as well as online resources to assist the client. At the same time the exercise and nutrition phases are implemented a portion of the time spent during sessions will be spent assessing the client's physical symptoms as well as the client's cognitive and emotional reactions to the changes they are making in their lives. Further the mental health professional will ask the client to identify those cognitive, social and environmental factors which may be discouraging those changes. The remainder of the session will consist of an ongoing assessment of the client's personal skills, abilities and attitudes in order to identify areas which may need to be made addressed as the intervention progresses. This assessment will include but not be limited to the changes being made in the areas of nutrition and exercise and must also address the mental health concerns which caused the client to initially seek mental health services. References Bottomley, A. & Mckeown, J. (2008) Promoting nutrition for people with mental health problems. Nursing Standard, 22(49), 48-55. Curtis, L. T. & Patel, K. (2008) Nutritional and environmental approaches to preventing and treating autism and attention deficit hyperactivity disorder (ADHD): A review. The Journal of Alternative and Complementary Medicine, 14(1), 79-85. Freeman, M. P, Hibbeln, J. R., Wisner, K. L., Watchman, M. & Gelenburg, A. J. (2006) An open trial of omega-3 fatty acids for depression in pregnancy. Blackwell Munksgaard, 18, 21-24. Harvard Health Publications (2009) Diet and attention deficit hyperactivity disorder. Harvard Mental Health Letter. Retrieved from www.health.harvard.edu Hobday, R. A., Thomas, S., O'Donovan, A., Murphy, M. & Pinching, A. J. (2008) dietary intervention in chronic fatigue syndrome. Journal of Human Nutrition and Diet, 21, 141-149. Iizaka, S., Tadaka, E. & Hiromi, S. (2008) Comprehensive assessment of nutritional status and associated factors in the healthy, community-dwelling elderly. Japan Geriatrics Society, 24-31. Isenring, E. (2008) Nutrition and mental health research: Where to from here? Nutrition and Dietetics, 65, 4-5 Jacka, F. & Berk, M. (2007) Food for thought. Acta Neuropschiatrica, 19, 321-323. MacDonell, J. (2009) The role of the dietician in improving mental wellbeing. Mental Health Practice, 12(6), 21-22. Porter, J. & Evans (2008) Nutrition and mental health research in Australia and New Zealand: A review of progress and directions for the future. Nutrition & Dietetics, 65, 6-9. Quinn, C. (2009) Supplements for mental health. Mental Health Practice, 12(9), 26-27 Schoo, A. (2008) Counseling: Working with different personalities and behaviors to improve and maintain mental and physical well-being. International Journal of Reality Therapy, 28(1), 34-40. Sutherland, J. E., Sutherland, S. J., & Hoehns, J. D. (2003) Achieving the best outcome in treatment of depression. The Journal of Family Practice, 52(3), 201-209. Sykes, K. (2009) Healthy steps. Occupational Health, 61(9), 40-43. |
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