It starts with Mom

It's so good to be back! I love my morning routine, which involves getting up, checking my email, giving milk to the cats, working out, fixing my coffee, then settling in for an hour or two of reading research that I end up sharing in my blogs. It's been about a month since I've been able to indulge that routine, and I am so glad to be back in the groove! Today I'm going to share some more research about what happens to the brains of developing babies whose mothers don't get enough omega-3 fatty acids. This time we're looking at linolenic acid (ALA), which comes primarily from flaxseed oil and nuts. This omega-3 appears to be important for the metabolism of the neurotransmitter dopamine.

When ALA is deficient, in the hippocampus, levels of enzymes that help to create dopamine from its building blocks drop. There is also a reduction in the number of vesicles that transport the finished product, dopamine, to where it can be released and used as a neurotransmitter. As a result, dopamine levels may back up in the neuron, which the researchers in this study propose may potentially damage the terminals in charge of processing dopamine.

In the cortex and striatum, under these same conditions, there is an increase in dopamine receptor levels. These same researchers propose that this is some sort of compensatory mechanism that allows cells "downstream" from the problem to maximize their ability to capture and use what dopamine is available.

Dopamine is important for impulse control. It is also the focus of much Parkinson's disease research. The D2 receptor mentioned in this study is especially important for managing weight, carbohydrate cravings, and addictions.

Could it be that many of the chronic problems medical professionals deal with and that we as people live with...have their origin before we're even born?

I've been saying for years that the population that needs the focus of our preventive nutrition and medical education is women of childbearing age. If we don't catch problems then, and if we focus on telling them what NOT to eat instead of helping them best eat for two...well, unfortunately, it may end up being job security for anyone whose work uniform includes a lab coat.

Kuperstein F, Eilam R, Yavin E. Altered expression of key dopaminergic regulatory proteins in the postnatal brain following perinatal n-3 fatty acid dietary deficiency. J Neurochem. 2008 Jul;106(2):662-71.

Great news for you readers struggling with infertility!

I'm going to be a little less active for about a week here, but it's for an important reason that will hopefully serve at least a few of you who regularly visit my blog!

For the past few years I've been training colleagues around the country in some of the practical aspects of using nutrition to help with mental health problems. One of the areas where these issues abound is in fertility treatment. So I've been actively using the same concepts that work for anxiety and depression to help with infertility. The colleagues I've been working with, as we've gained an understanding of how it all fits together, have been reporting some wonderful success stories in clients who had been told they might never have a child of their own.

As we've grown as a network, we've gained the attention of sponsors, and one of those sponsors, Nutrabella, approached me about collaborating with them to contribute to a fertility report that will be appearing in East Coast newspapers this coming Friday--the Washington Post, Wall Street Journal, and Boston Globe, to name a few. Another sponsor, SGJ Consulting, contributed to the project as well. It's been a great team to work with from start to finish!

That kind of opportunity has the potential to reach quite a few people (2.1 million is what has been projected)! So I've been busy making sure we're ready to handle the traffic and that everyone who's been going through my training is ready to take referrals.

If you know of anyone who is struggling with infertility, please tell them we have several resources:
(1) our network's blog,
(2) individual consultations, and
(3) Fertile Intentions (TM), our new couples infertility spa day experience, in Marina del Rey, California.

This is such a great audience with whom to share the message that there are many options outside of medication for helping with stress-related problems.

I'll be back in about a week, hopefully with some exciting updates, and definitely with more comments on nutrition and mental health.

Have a wonderful rest of August in the meantime!

A little about vitamins...and a lot about food and mood

My friend Diane Whelan and I toured a vitamin factory yesterday. Was that ever interesting! I guess you just assume all those pills show up in all those bottles on their own. I learned so much about what it takes to grow the herbs, extract the active ingredients...even how much it takes to be an international business and sell different formulations to different countries while being in compliance with labeling regulations and varying cultural nutritional needs.

At one point our guide hand-pressed me a personal supplement the old-fashioned way.

Diane works with a product line called Nutrilite. The products are very high quality, and what really struck me as we toured the factory was how proud the employees were of their work.

You can learn more about this product line at this link: http://www.afterthediet.com/whyvitamins.htm

I receive no commission from Nutrilite for sharing this information. I simply like to share good information and products when I do see them.

Below is some great information about food and mood from Nutrilite that you also may enjoy.

You and Your Mood: What’s Food Got to Do with It?
Duke Johnson, M.D.
Medical Director, Nutrilite Center for Optimal Health

Do you head straight for the ice cream after an especially hard day at work? It seems like a no-brainer that your mood affects your food choices. But did you know that food can also affect your mood? There are foods that can give you a boost when you need one.

The food-mood connection
It starts with chemicals in your brain, called neurotransmitters. They act like a one-way command center, telling your brain cells what message to pass on to all the other cells. Two neurotransmitters always send a “pay attention, stay alert” message, while another one always sends a “calm down, relax” message.

Now, consider this: If your diet doesn’t include the right nutrients, your brain won’t make enough neurotransmitters to send messages at optimum levels. And if you eat (or don’t eat) specific nutrients, your brain selectively makes certain neurotransmitters but not others.

Generally speaking, the following nutrients all affect neurotransmitter production:

Proteins.
Carbohydrates.
Vitamins.
Minerals.
For example, if you don’t consume enough food with the right amount of B vitamins, vitamin C, selenium, and magnesium, your body won’t produce or store enough of these critical chemical messengers.

And that’s how the foods you eat (or don’t eat) affect your mood, energy levels, stress, and sleep habits.

And in case you want to know their names, the “high-alert” neurotransmitters are dopamine and norepinephrine. And serotonin has a calming, anxiety-reducing effect.

How to say it:
(emphasize the syllable in bold):

Neurotransmitters: Nurr-oh-trans-mitters.
Dopamine: Dope-a-mean.
Norepinephrine: Nor-eppa-neff-rinn.
Serotonin: Ser-oh-tone-in.
Feeling down?
Eat a small amount of carbs, like whole-grain cereal, whole-wheat pasta, or yogurt with fruit. That stimulates serotonin production, and relaxation and calm will follow.

Want more energy?
But if you’re gearing up for an exam or an interview, you should eat some lean protein with healthy carbs. That will trigger dopamine and norepinephrine, to get your mental juices flowing.

Nutrient
Food
Results
How

Lean protein
Meat, low-fat dairy, and eggs
Increases your alertness and concentration
Increased production and activity of dopamine and norepinephrine

Healthy carbohydrates
Brown rice, plain oatmeal, whole-grain cereals, and fresh fruit
Improves your mood, curbs your food cravings, and helps you sleep
Increased production and activity of serotonin

Omega-3 fats
Salmon, tuna, sardines, anchovies walnuts, and flaxseed

Increased production and activity of serotonin


Brain drainers and brain boosters
Be careful about grabbing chips, crackers, or fast food when you’re feeling down or stressed. It definitely can make you feel better, because processed foods high in sugar and saturated fat give you a burst of energy. But not too much later, you’ll crash and feel irritable and anxious.

And then, to feel better, it’s natural to return to the food and drink that gave you energy … but it’s easy to see where that leads – more sugar and more unhealthy fats, another boost and another crash.

Break this cycle and feel better – in a healthier, more lasting way, by eating these brain boosters, instead:

Brain drainers
Brain boosters

Coffee and a doughnut for breakfast
Oatmeal topped with berries, and a hard-boiled egg

Hamburger, fries, and soda for lunch
Turkey sandwich on whole-grain bread and veggies

Frozen fish nuggets and tater tots for dinner
Grilled salmon, broccoli, brown rice, and a green salad


Comfort foods
Sometimes the only food that will do is the meatloaf and mashed potatoes Mom used to make when you were a kid. Or maybe it’s tomato soup and grilled cheese sandwiches. The strong emotional connection of these comfort foods stimulates release of the “feel good” neurotransmitters.

And to balance out the comfort food, up the nutritional quality. If you want a cookie, make it oatmeal raisin or fruit filled. Buy lower-fat ice cream or single-serve popsicles. Throw some veggies on that pizza.

What you drink matters, too
Do you reach for a cup of java or cola first thing in the morning or a glass of wine in the evening? Caffeine and alcohol can improve your mood, but too much of a good thing can have not-so-good consequences. Three hundred milligrams of caffeine – roughly what you get from three cups of brewed coffee – can increase your alertness and concentration. But more than 300 mg can make you nervous and jittery.

Alcohol has its pros and cons, too. Two drinks a day for men and one for women is linked to a lower risk of heart disease, but more than that may lead to weight gain, difficulty sleeping, and decreased powers of concentration. Too much alcohol also makes it easier to choose foods that don’t support a good mood.

Eat well to feel good
Feed your brain the best food you can! Choose a balanced diet of lean protein, healthy carbs, and omega-3 fats. Make sure to take a multivitamin that delivers the right blend of vitamins, minerals, and phytonutrients. Add regular exercise, enough sleep, and decisions that fit your lifestyle priorities. And you’ve got a no-brainer recipe for mastering your mood.

So tell me again....WHY are we telling pregnant women to avoid eating fish?

This is one of those issues that simply drives me crazy. The Food and Drug Administration, several years ago, because of mercury content, identified four fish that might be harmful to consume during pregnancy. Those four fish were king mackerel, tilefish, swordfish, and shark.

For the recored, in 26 years of doing this work, I have yet to EVER have ANYONE at ANY point in their life tell me in a diet recall that they eat mackerel (too fishy), shark (eeeuuw!!!), or tilefish (what the heck is a tilefish?). Swordfish is a rare item that comes up.

Let's count those again. Four fish. Mackerel. Shark. Tilefish. Swordfish.

In the time that this warning has come out, consumption of ALL fish has decreased, by about one sixth (17%).

Why have we overgeneralized? Because scary headlines are what sell newspapers and news broadcasts. And when newspapers sell and news shows are watched, newspapers and television stations make more money from advertising.

Did you know, that the losses associated with this preventative measure may outweigh the benefits? According to the Harvard Review, if pregnant women were to eat the same amount of fish they normally do, but replaced fish high in mercury with fish low in mercury, cognitive development benefits could be achieved with virtually no nutritional losses. When those cognitive development benefits are taken into consideration, if those women were to cut their fish consumption by one-sixth, exactly what has happened, the nutritional benefit derived drops by 80%.

A new study suggests that omega-3 deficiency during pregnancy may have effects years later. A group of researchers who had reported that supplementing pregnant and lactating women with omega-3 fatty acids during pregnancy resulted in higher IQ scores in their children 4 years after birth, retested the same children at 7 years. The women in this study either took 10 ml of cod liver oil or corn oil from the 18th week of pregnancy until 3 months after their babies were born. Mothers with high levels of plasma ALA and DHA (two omega-3 fatty acids) had children who better learned information, organized it, and later used it in practical situations.

Again...'splain me why we're telling pregnant women to be afraid of fish?

http://www.hno.harvard.edu/gazette/2005/10.20/26-merc.html

Helland IB, Smith L, Blomén B, Saarem K, Saugstad OD, Drevon CA. Effect of supplementing pregnant and lactating mothers with n-3 very-long-chain fatty acids on children's IQ and body mass index at 7 years of age. Pediatrics. 2008 Aug;122(2):e472-9.

Carnitine supplementation enhances Depakote activity

For the last few months I've been reading carnitine research (there's a boatload of it and it's completely kept me out of trouble!)

It is pretty well documented that people taking valproic acid (Depakote) have a problem maintaining carnitine levels. To the point where, after doing this research, I have no problem saying that anyone on Depakote should automatically be placed on L-carnitine as well.

Anyway, I just found an article reporting that carnitine supplementation in conjunction with Depakote use enhanced the levels of Depakote in the brain. In other words, if you use carnitine while using Depakote, you won't need as much Depakote. And if you're not using as much Depakote, you're not as likely to experience the side effects that make people not want to comply with the regimen, such as weight gain, infertility, acne, yadayadayada.

Monika's Bottom Line
Doctors should have a carnitine chip inserted in the medication-prescribing region of the brain that does not allow them to script this med without also scripting this supplement.

Sakemi K, Takada G. Effect of carnitine on valproic acid concentrations in serum, brain, and liver. Pediatr Neurol. 1998 Apr;18(4):331-3.

Topamax and kidneys...these two will probably never be BFF's

I've noticed in looking at my blog statistics that a previous entry on kidney stones resulting from topiramate (Topamax) use continues to be one of my most visited pages on this blog. So when I found more information about this medication and its effect on kidneys I wanted to be sure to share it.

Within 5 days of starting topiramate, the six subjects in this study experienced an average drop of calcium in their urine of about 31% and of citrate by about 40%. When calcium and citrate are not showing up in the urine, it's likely because it's accumulating elsewhere. Like in kidney stones.

Interestingly, increasing the topiramate dose seemed to improve calcium readings and to worsen citrate readings. Meaning you might get less of one kind of kidney stone and more of another.

The authors of this study said that the degree of reduction of urinary citrate was profound enough to be compared to the clinical presentation of renal tubular acidosis. This is a condition in which the body's pH is shifted to an unhealthy level, promoting important changes such as bone demineralization. And THIS will cause rickets in children and osteomalacia in adults. These are not things you will see or feel in those first few days. You need to measure them clinically.

I would strongly recommend, if you and your physician have concluded that the absolute only way to manage your bipolar disorder, your migraine, or your epilepsy, is with topiramate, that you closely monitor your urinary metabolites to be sure you're not doing more harm than good.

And if you're one of those souls who's been convinced that it might be nice to try topiramate to see if it helps you lose weight, consider that you might not just be
losing fat, you might also be losing bone. What's the point of being thin if you have to be sick when you get there?

The only way to know is to monitor. Please don't stick your head in the sand and hope it's not happening to you.

Warner BW, LaGrange CA, Tucker T, Bensalem-Owen M, Pais VM Jr. Induction of progressive profound hypocitraturia with increasing doses of topiramate. Urology. 2008 Jul;72(1):29-32; discussion 32-3.



I found a photo of a kidney stone on the 'net. Imagine trying how it feels to pass something this big through an opening about as big as a piece of cooked pasta. Now you know why I'm trying to get your attention!

This topic hit home for me and because of that I want to pass along a very important warning

Hello everyone,

Last night I attended a memorial service for a neighbor. A month ago she committed suicide, in a very violent fashion. Most of us were dumbfounded, as this neighbor, to all of us, was a healer, kind, loving, always smiling. What most of us did not know, until last night, as her daughter spoke, was that our friend struggled with bipolar disorder. She had been on many different medications, and apparently had a rotation going of different medications. The issue seemed to be that she would develop a tolerance to one regime, so she would rotate through different cocktails as one set lost its effect.

Apparently, on her own, she decided to wean herself off the medications. No supervision from her doctor.

I wonder if this is how she got herself into trouble.

I do my best in this blog to stay neutral, and let you, the readers, decide if medication is for you, or if you'd rather choose an alternative option. I still feel that way.

However, what I do want to insist on, after this personal experience, is that if you are on medications, that you do not manage the use of these medications, or even alternative options, on your own. Whether it's in a bottle or from a plant or a food, when you use chemicals to alter your brain chemistry, you alter your brain chemistry. Once the compound is in your body, regardless of its origin, you really don't have any control over where, when, and how this compound is going to work.

Please do not operate on the assumption that because you are "getting off meds", that what you are doing is safe. It can be, but only if done correctly. Please do not assume that because what you are taking is organic and/or was not sold to you by a pharmaceutical company, that you're in good hands. You may...or you may not be.

It can be very hard to reach out for help when the problem you have is a mental health issue. I lived just yards from this neighbor, she knew what I did for a living, and never once did she ask me for any information. But the important thing to remember about a mental health issue is that it affects how you think, reason, feel, and act. Even if you feel that you're in control, it's always important to have at least one human sounding board to depend on when making decisions affecting how your brain functions.

I don't want any of you to ever think I said anything to encourage you to endanger yourself. If I present new information that you think might be helpful, please download it and share it with your provider. Don't act on it alone. I want all of you to be around as long as I can come up with new and helpful information to post on this blog.