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Beyond Medicamon Beyond Medicaon: HolisNc Treatment for Children and Aouth with Mental Health Challenges DFood and Func3onal E ,edicine Natalie Sadler, MD Children’s Mental Health Summit September 28-­‐29, 2012 Bac7ground for Change HolisNc Fiew: Body, ,ind, 0pirit of paNent Undergrad: ,ath major, NutriNon minor FuncNonal ,edicine perspecNNe Natural curiosity as to why things happen Events that led me to thi17'di@erently and loo7'for underlying causes4 • 1983 Dean of ,edical 0chool • 1987 Residency 7 lead poisoning causing psychosis – Thyroid, BS, Folic acid UNC Pwight Evans ,P • 2001 Pt asked that I watch TV show 20/20 on 0A,e • 2001 New pt requested an alternave, nutrional approach to her treatment. Abram /o\er ,P spoke at UNC e IntegraNNe ,edicin Conference 0ept 2001. Holis3c Evaluaon • Psychiatric evalua30n including religion, spirituality, abuse, Nitamins, diet, food allergies/sensiNNiNes. • Symptom chec7'lists for thyroid, adrenals, yeast/Candida, sugar metabolism, neurotransmiPers, Nitamin deficiencies, autonomic nerNous system/sympatheNc/parasympatheNc. • Sensory ProDle E6es3onnaire for sensiNNity to light, sound, touch, taste and smell _sensory integraon). • Func3onal Acuity Contrast Test (FACTI eye test for essenNal fay acids in the reNna. PHA needed to see shades of gray. • Func3onal Medicine Tes3ng for biomedical factors to determine nutrient imbalances and metabolic dysfuncNon Holis3c Treatment • Bringing the nutrient imbalances back into balance. • Address diet changes, sleep and eaercise to sustain good health. • IdenNfying the underlying psychological issues ing and work to resolNe them using conNenNonal psychotherapy and alternaNe therapies. • bearning good coping skills to handle life and stress: Mindfulness, Heartmath, yoga • Address any sensory integraon and/or autonomic nerNous system dysfuncNon. A Holisc Approach to Mental Health Challenges in':;ildren'"1d'Jouth What a child eats ma7es a di@erence in their mental health. Epigene3cs,'8&ne'&Mpression, is a new way to look at mental health issues. Funconal medicine lab may tesng be helpful in determining metabolic malfuncon and nutrient imbalances that underlie mental health issues. A Holisc Approach to Mental Health Challenges in':;ildren'"1d'Jouth What a child eats ma7es a di@erence in their mental health. What a Child EatsO Liu,et al, c ,.lnutriNon at Age 3 Aears and Eaternaliding r BehaNio Problems at Ages 8, 11, and 17 Yearse Am J Psychiatry+;S1:200f72013, NoNember 200g The'?ore indicators of malnutri3on there at age 3 were, the'8reater the an3social : behavior •41S'increase in aggression at age T. •51S'increase in violent and an3social ge behaviors at a 17. What a Child EatsO Bouchard PhD, ,aryse, et al, Aenon7Deficit/Hyperacvity Disorder and Urinary ,etabolites of hrganophosphate Pescides Pediatrics 2010i 12f:S e12707e1277 Children with organophosphates in their urine higher than the median were twice as likely to have A-AD. Increased+Risk+<f AP/P+Yssociated+jith+Tarly+Taposure to+UesNcides9+UCBs+kY,A. 2010;O:g_1):27-­‐28. Children exposed to organophosphates from fruits and vegetables had higher ris7'of developing ADHD. A good reason for organic fruits and vegetablesX What a Child EatsO Anita 0. Wells, Altera3ons'%n'?ood'"Ye*'2hanging'#o'"'$owZ9"t')iet. et al, BriNsh Journal of NutriNon _1888), 78, 23730 23 Need for good fats in diet4 •bowering dietary fat content from g1 to 2f l of energy may have adNerse e\ects on mood in 10 men, 10 women age 207 37yrs. Aer 1 month anger/hos3lity signiDcantly increased, tension/anaiety stayed unchanged. Those on the higher fat diet showed decrease'%1'"18&r/hoslity and tension/anxiety. What a Child EatsO k.cka PhP,Felice, et al, Associa3on of Western and Tradi3onal Diets ession with Depr and Anxiety in Women, Am J Psychiatry 2010;167:305-­‐311 •0tudy of habitual diet paOerns of 10gS women in Australia ages 20 783 as rela3ng to mental . illness •Tradi30nal'-%et: Negetables, fruit, beef, lamb, fish, whole grains •Western'-%et: processed or fried foods, processed meats, refined mour products, sugary products, mavored milk drinks and beer •,0dern Diet: fruits, salads, fish, tofu, beans, yogurt, red wine What a Child EatsO k.cka PhP,Felice, et al, Associa3on of Western and Tradi3onal Diets ession with Depr and Anxiety in Women, Am J Psychiatry 2010;167:305-­‐311 Results: •Tradi30nal'-%et: less chance of having depression, dysthymia and anaiety, lower oNerall psychological symptoms •Western'-%et4'high correla.on$with oNerall psychological symptoms •,0dern Diet4 slight$correla.on$with anaiety and depression Associaon between habitual diet quality and high-­‐ prevalance mental disorders What a Child EatsO k.cka PhP,Felice, Associa3on between diet quality and depressed n mood i Adolescents4 Results from'#he'Fustralian'Aealthy'!eighborhood'(tudy ,Australian and New nealand kournal of Psychiatry, 2010, ggG gOf7gg5 •0tudy eaamined 711g adolescents age 1071g for diet quality and depression – Followed Dietary Guidelines for Children and Adolescents in Australia and recognized as important components of a healthy diet. •Conclusion: _ow intake of nutrient-­‐dense foods and/or high intake of high energy, nutrient-­‐poor foods increase the likelihood of depression in adolescents. The poorer the diet quality, the higher the ris7'for depression What a Child EatsO k.cka PhP, Felicia, A et all, Perspec3ve Study in Diet Euality and in ,ental Aealth Adolescents, Ubo0 hLE, 0ept 22, 2011 •Three quarters o9'$ifeme psychiatri2')isorders emerge in adolescence or early adulthood, and that a recent naonal survey showed more than 22S'of adolescents aged 13 to 1T years had already eMperienced a clinically significant mental health problem. •20fg Australian adolescents aged 11 to 18 years at baseline who were parNcipants in a project known as It’s Your Move, aimed to increase the capacity of schools to promote healthy eang and physical acNNity. Assessed in 200f and 2007. What a Child EatsO k.cka PhP, Felicia, A et all, Perspec3ve Study in Diet Euality and in ,ental Aealth Adolescents, Ubo0 hLE, 0ept 22, 2011 •A healthy diet was defined as one that included fruit and Negetables as core food groups and included both 2 or more serNings of fruit per day and g or getables, more serNings of Ne as well as general avoidance of processed including foods chips, fried foods, chocolate, sweets, and ice cream. •An unhealthy diet was high in snac7'and ds. processed foo What a Child EatsO k.cka PhP, Felicia, A et all, Perspec3ve Study in Diet Euality and in ,ental Aealth Adolescents, Ubo0 hLE, 0ept 22, 2011 •The inNesNgators found higher that healthy diet scores at baseline predicted higher (beOerI Pediatric E6ality of _ife Inventory scores at follow-­‐up, whereas higher unhealthy baseline scores predicted poorer mental health. •Adolescents who improved the quality of their diets also experienced'%mproved mental';ealth. In contrast, those whose dietary quality deteriorated eaperience a worsening of their mental health status. What a Child EatsO cWe know that diet quality has a real impact on your immune+*ystem+.nd+<aidaNNe+*tress. It affects gene expression, and it has a potent impact on the neurotrophic factors, including brai(7%'riNed neurotrophic factor, which we know are parcularly relevant in psychiatric illness. We think it is plausible that through dietary change we can modulate these biologic factors and, over 3me, modulate the ris7 for depression and anxiety.e Felica+kacka,+UhP Medscape Medical News hct 1g, 2011 What a Child EatsO Growin8'2*0ps in';ealthy'>0ils results in food products that offer healthy nutrients. • Soil that has bee1'?anaged organically has more microorganisms. /.der A. c The role of organic maPer in the introducNon of bioferlizers and biocontrol agents to soil.e+Wn: Chen A, Avnimelech A, eds. The Role of Organic MaGer in Modern Weatherhand Marm Agriculture. Boston: ,arNnus Nijho\ Publishers, photo by Elizabeth oibbs 1986:169-­‐180.i Henis A. cSoil microorganisms, soil organic maPer Nlity. and soil fer e+Wn: Chen A, ANnimelech The A, eds. Role of Organic Maer in Modern Agriculture.+Hoston: ,arNnus Nijho\ Publishers, 188S:287fg. • Th&'Cresen2&'0f these microorganisms at least parally'&MClains the trend showing a higher'?ineral content in organic'2rops. What a Child EatsO What a Child EatsO What a Child EatsO Recommendaons: Organic, Biodynamic, Permaculture, Chemical7free, Seasonal frui-*+.nd vegetables Castle ,aine Marm at the Carrboro Marmer)s ,arket photo by Pebbie Roos What a Child EatsO Recommendaons: Eggs from free7&ange+>hickens Standing guard at Fickle Creek Farm photo by Roland ,cReynolds What a Child EatsO Conven30nal vs. Grass-­‐fed .eef Data from4 $ Animal Sci L0MM5N 30LON42079-­‐88. What a Child EatsO Good fats in local, grass-­‐fed dairy Dhiman, T. R., Anand o. R. , et al. _1888). pConjugated linoleic acid content of milk from cows fed different J diets.p Dairy Sci 82_10): 21gS7fS. What a Child EatsO Recommendaons: Grass-fed, pasture-raised beef, lamb, pork, chickens, turkeys Baldwin Mamily Marm photo by Elier Amy What a Child EatsO Recommendaons: oood oils: hrganic eatra Nirgin oliNe oil, coconut oil, organic buPer, ghee, lard Nuts and 0eeds _soaked and roasted) Mresh herbs and spices for seasoning Raw honey as a sweetener Bee photo by Pebbie Roos bactofermented Negetables 0oak and sprout whole grains What a Child EatsO Recommendaons: Eat food as it comes from the farm NutriNNe dense bocal: where you know your farmer, farmer’s market, C0A _Community 0upported Agriculture) Perrywinkle Marm photo by Pebbie Roos Clinical Case 1 • f year old boy with high funcNoning ental perNasiNe deNelopm delays referred by occupaonal therapist. • Piet was processed to hq. • Mom agreed to change his diet to Weston A Price/0ally Mallon Nourishing TradiQons, chrganic food as it comes from the farm diete, lactofermented Negetables. He kept working with hT. • hne year later he had no symptoms of delay according to hT. A Holisc Approach to Mental Health Challenges in':;ildren'"1d'Jouth Epigene3cs, gene eMpression, is a new way to look at mental health issues.
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