Nutrition And Mental Health

Question 1

Is diet associated with mental health?

Answer 1

Yes however some vitamins can cause neurological/mental symptoms by themselves

Question 2

Examples of vitamin deficiencies that can cause mental health/neurological symptoms

Answer 2

Niacin = dementia like symptoms

Vitamin B12 (cobalamin) = depression, psychosis, demyelination of spinal tracts, irritability/agitation

Vitamin B9 = decreased dopamine/NE/serotonin levels in the body

vitamin B12 deficiencies is especially susceptible in elderly and patients with GI dysfunctions/surgeries

Vitamin C/D/B/E = worsens depression and cognition

Iron and zinc = helps myelination and neurotransmitter metabolism

Question 3

What types of questions should you ask as screening questions for nutritional deficiencies

Answer 3

can you tell me what you eat during a typical day?

What are your favorite foods/snacks?

Are there any foods you avoid/tell me why you avoid these foods?

Question 4

Depression and diet

Answer 4

While inconclusive, it is known that a general healthy dietary pattern (nutrient rich foods) decreases risks of depression
- health diet = fruits/vegetables/whole grains and lean proteins

increased processed food and refined sugar = increased expression

hard to make a definitive connection since it isn’t sure if depression causes nutrient deficiencies or if nutrient deficiencies cause depression

Question 5

Omega-3 fatty acids in mood disorders

- specifically levels of EPA/DHA acids

Answer 5

Shows promising in depression especially

• the breakdown of omega-3 -> EPA and DHA = shows some correlation in decreasing depression
• is only recommended currently for adjuvant therapy with SSRI/SNRI

Some evidence in bipolar but only should be used in depression phase
- also because it isnt known if giving omega-3 can induce mania from depression in bipolar 1 (similar to SSRI), it is not a first line therapy by itself

typical doses recommended = 1-2g per day

Question 6

What are the most common secondary health side effects to treating psychiatric conditions with proper medications?

Answer 6

Obesity

Diabetes

Heart disease/CAD

Question 7

What rates does obesity increase when a patient has a mental health condition?

Answer 7

1.5x

Question 8

Which psychiatric medications are associated with weight LOSS rather than weight gain?

Answer 8

Bupropion (anti-depressant)

Topiramate (mood stabilizer)

Zonisamide (mood stabilizer)

Question 9

What is the cut off for weight gain with use of psychiatric meds?

Answer 9

> 5% weight gain after one month of use

- should consider switching in this case or need to review weight control strategies at the very least

Question 10

What specific psychiatric medications are known to cause serious weight gain?

Answer 10

Antipsychotics have the highest rates of weight gain amount groups of psychiatric medications

• *Top 2**
• olanzapine
• clozapine

Question 11

Options to help combat weight gain due to use of psychiatric medications

Answer 11

diet and exercise should always be 1st line recommendations

Pharmacotherapy options include:
- metformin = treats diabetes associated with psychiatric meds
- topiramate = treats weight gain as off label use
(On label use = anticonvulsant)

Question 12

Bipolar treatments and nutritional health

Answer 12

68% of these patients are overweight/obese to begin with
- only gets worth with most medications

• CVD = most common cause of death*
• occurs roughly 10 yrs earlier than gen pop.

Question 13

What is the increased prevalence of obesity in schizophrenia patients

Answer 13

2x higher compared to gen population

Question 14

What is the leading exercise/diet regiments recommended for patients who are looking to lose weight/prevent weight gain while taking psychiatric medications?

Answer 14

• Eat 5 servings of fruits/vegetables a day
• avoid processed/high sugar foods
• decrease whatever the daily goal kcal count is before intervention down 500 kcal/day and encourage this diet pattern

this method has been shown to work with weight loss regardless of what medication the patient is on

Question 15

Relationship between food groups and the feeling of satiety after eating 500 calories worth?

Answer 15

Oil = least satiety
- processed foods falls here

Cheese/dairy

Meat

Grains/beans

Fruits/veggies = most satiety

Question 16

How to calculate energy density of a food

Answer 16

Kcal/serving size (in grams)

• if ratio is less than 1 = low density
  (vegetables and fruits are most common)
• if ratio is 1-2 = moderate density
• if ratio is greater than 2 = high density
  (This is the area that should be cut when trying to lose weight)

Question 17

Ways to reduce energy-density in a recipe

Answer 17

1) reduce the fat of the ingredients themselves
2) water-incorporation (add fruits and vegetables to the recipe with less substation)
3) combo of both